经尿道膀胱肿瘤钬激光切除术与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的临床效果研究  

Clinical effect of ransurethral holmium laser excision tumor and transurethral resection of bladder tumor in the treatment of non-muscular invasive bladder cancer

作　　者：于国强 魏曙光[1] 贾招辉[1] 张晨阳 刘刚[1] YU Guo-qiang;WEI Shu-guang;JIA Zhao-hui;ZHANG Chen-yang;LIU Gang(Department of Urology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,CHINA)

机构地区：[1]河南科技大学第一附属医院泌尿外科,河南洛阳471000

出　　处：《海南医学》2024年第23期3379-3382,共4页Hainan Medical Journal

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20210912)。

摘　　要：目的比较经尿道膀胱肿瘤钬激光切除术(HOLRBT)与经尿道膀胱肿瘤电切术(TURBT)治疗非肌层浸润性膀胱癌(NMIBC)的临床效果。方法选择2021年1月至2022年12月河南科技大学第一附属医院收治的80例NMIBC患者作为研究对象,按照随机数表法分为观察组和对照组各40例。对照组患者采用TURBT治疗,观察组患者采用HOLRBT治疗,治疗出院后均随访1年。比较两组患者的病理诊断准确率、围术期情况[手术时间、术中出血量、肉眼血尿持续时间、尿管留置时间、膀胱冲洗时间及住院时间],以及术前和术后24 h的血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,并比较两组患者术后并发症发生率以及随访1年内的复发率。结果观察组患者的病理诊断准确率为87.50%,明显高于对照组的67.50%,差异有统计学意义(P<0.05)。两组患者的手术时间、术中出血量和住院时间比较差异均无统计学意义(P>0.05),而观察组患者的肉眼血尿持续时间、尿管留置时间、膀胱冲洗时间分别为(1.35±0.42)d、(2.55±0.47)d、(1.58±0.40)d,明显短于对照组的(1.66±0.48)d、(3.05±0.56)d、(1.96±0.43)d,差异均有统计学意义(P<0.05)。术后24 h,观察组患者的血清CRP、TNF-α、IL-6水平分别为(16.32±2.48)mg/L、(39.48±3.60)pg/mL、(54.02±4.75)pg/mL,明显低于对照组的(21.33±2.75)mg/L、(46.21±3.79)pg/mL、(61.27±5.11)pg/mL,差异均有统计学意义(P<0.05)。观察组患者术后并发症总发生率为5.00%,明显低于对照组的20.00%,差异有统计学意义(P<0.05);随访1年,观察组患者失访1例、对照组失访2例,观察组患者随访1年内的复发率为2.56%,略低于对照组的10.53%,但差异无统计学意义(P>0.05)。结论与TURBT相比,HOLRBT治疗NMIBC患者效果明显,对患者损伤更小,并发症发生率低,值得临床推广。Objective To analyze and compare the clinical effect of transurethral holmium laser resection of bladder tumor(HOLRBT)and transurethral resection of bladder tumor(TURBT)in the treatment of non-muscular invasive bladder cancer(NMIBC).Methods A total of 80 NMIBC patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2021 to December 2022 were selected and divided into an observation group and a control group according to random number table method,with 40 patients in each group.Patients in the control group received TURBT,and those in the observation group received HOLRBT.Both groups of patients were followed up for one year after discharge.The accuracy rate of pathological diagnosis and perioperative situation(operation time,intraoperative blood loss,gross hematuria duration,catheter indwelling time,bladder irrigation time,and length of hospital stay)between the two groups were compared;the changes of serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)before and at 24 h after surgery were compared between the two groups;the incidence of postoperative complications and the recurrence rate within 1 year of follow-up were also compared.Results The accuracy of pathological diagnosis in the observation group was 87.50%,significantly higher than the control group's 67.50%(P<0.05).There was no significant difference in operation time,intraoperative blood loss,and length of hospital stay between the two groups(P>0.05);the gross hematuria duration,catheter indwelling time,and bladder flushing time in the observation group were(1.35±0.42)d,(2.55±0.47)d,and(1.58±0.40)d,respectively,which were significantly shorter than(1.66±0.48)d,(3.05±0.56)d,and(1.96±0.43)d in the control group(P<0.05).At 24 hours after surgery,the serum levels of CRP,TNF-α,and IL-6 in the observation group were(16.32±2.48)mg/L,(39.48±3.60)pg/mL,and(54.02±4.75)pg/mL,respectively,which were significantly lower than(21.33±2.75)mg/L,(46.21±3.79)pg/mL,and(61.2

关 键 词：非肌层浸润性膀胱癌 经尿道膀胱肿瘤钬激光切除术 经尿道膀胱肿瘤电切术 炎症因子 疗效 并发症 

分 类 号：R737.14[医药卫生—肿瘤]