经尿道膀胱黏膜电切术联合A群链球菌膀胱灌注治疗膀胱白斑的疗效分析  

Efficacy analysis of transurethral resection of bladder mucosa combined with group A streptococcus intravesical instillation in the treatment of bladder leukoplakia

作　　者：朱少杰 张友强 林明恩[1] ZHU Shaojie;ZHANG Youqiang;LIN Mingen(Department of Urology,The First Affiliated Hospital of Shantou University Medical College,Shantou 515100,China;不详)

机构地区：[1]汕头大学医学院第一附属医院泌尿外科,广东汕头515100 [2]汕头潮南民生医院泌尿外科,广东汕头515100

出　　处：《医师在线》2025年第3期63-66,共4页Journal of Doctors Online

摘　　要：目的分析经尿道膀胱黏膜电切术联合A群链球菌膀胱灌注治疗膀胱白斑的疗效。方法根据治疗方式的不同,将2018年1月~2022年12月汕头潮南民生医院收治的97例膀胱白斑患者分为单纯电切组(n=40)和电切+灌注组(n=57)。单纯电切组接受单纯经尿道膀胱黏膜电切术治疗,电切+灌注组在单纯电切组治疗的基础上联合术后A群链球菌膀胱灌注治疗,比较两组患者的临床疗效,并于治疗前和治疗后分别检测和比较两组患者的尿动力学指标[最大尿流率(Q_(max))、最大膀胱容量(MCC)、膀胱顺应性(BC)],记录和比较术后并发症发生情况;于术后6个月,随访统计两组患者的复发、恶变情况。结果电切+灌注组的治疗总有效率为94.74%,高于单纯电切组的82.50%(P<0.05)。治疗后,电切+灌注组的Q_(max)、MCC、BC均高于单纯电切组(P<0.05)。电切+灌注组的术后并发症总发生率为12.28%,与单纯电切组的12.50%比较,差异无统计学意义(P>0.05)。电切+灌注组术后6个月的复发率为0.00%,低于单纯电切组的12.50%(P<0.05);两组患者随访期间均无发生恶变。结论膀胱白斑患者在经尿道膀胱黏膜电切术治疗的基础上联用A群链球菌膀胱灌注治疗的疗效显著,可改善患者尿动力学指标,降低术后复发率,且安全性良好。Objective To analyze the curative effect of transurethral resection of bladder mucosa combined with group A streptococcal bladder perfusion in the treatment of bladder leukoplakia.Methods According to the different treatment methods,97 patients with bladder leukoplakia admitted to Shantou Chaonan Minsheng Hospital from January 2018 to December 2022 were divided into simple resection group(n=40)and resection+perfusion group(n=57).The simple resection group received simple transurethral resection of the bladder mucosa,and the resection+perfusion group combined with postoperative group A streptococcal bladder perfusion therapy on the basis of the simple resection group.The clinical efficacy of the two groups was compared.The urodynamic indexes[maximum urinary flow rate(Q_(max)),maximum bladder volume(MCC),bladder compliance(BC)]of the two groups were detected and compared before and after treatment,and the incidence of postoperative complications was recorded and compared.At 6 months after operation,the recurrence and malignant transformation of the two groups were followed up.Results The total effective rate of the resection+perfusion group was 94.74%,which was higher than 82.50%in the simple resection group(P<0.05).After treatment,Q_(max),MCC and BC in resection+perfusion group were higher than those in the simple resection group(P<0.05).The total incidence of postoperative complications in the resection+perfusion group was 12.28%,which had no statistical significance compared with 12.50%in the simple resection group(P>0.05).The recurrence rate at 6 months after operation was 0.00%in the resection+perfusion group,which was lower than 12.50%in the simple resection group(P<0.05).No malignant changes occurred in both groups during follow-up.Conclusion On the basis of transurethral resection of the bladder mucosa in patients with bladder leukoplakia,the combined treatment with group A streptococcal bladder perfusion has a significant effect,can improve the urodynamic indexes of patients,reduce the postoperative recurr

关 键 词：膀胱白斑 经尿道膀胱黏膜电切术 膀胱灌注 A群链球菌 尿动力学 

分 类 号：R73[医药卫生—肿瘤]