经尿道钬激光剜除术对非肌层浸润性膀胱癌术后尿路功能恢复生活质量及预后的影响  

Impact of Transurethral Holmium Laser Enucleation of Bladder Tumor on Postoperative Urinary Function Recovery Quality of Life and Prognosis in Non-Muscle-Invasive Bladder Cancer

作　　者：吴德鸣 焦常宝[1] 陈健[1] 项平[2] WU Deming;JIAO Changbao;CHEN Jian(The First People's Hospital of Chuzhou,Bengbu Medical University,Anhui Chuzhou 239001,China)

机构地区：[1]蚌埠医科大学/滁州市第一人民医院泌尿外科,安徽滁州239001 [2]蚌埠医科大学/安徽省立医院泌尿外科,安徽合肥230001

出　　处：《河北医学》2025年第3期439-445,共7页Hebei Medicine

基　　金：2020年度安徽省自然科学基金项目,(编号:2008085MH251)。

摘　　要：目的:探究经尿道钬激光剜除术(HOLRBT)对非肌层浸润性膀胱癌(NMIBC)术后尿路功能恢复、生活质量及预后的影响。方法:选取2020年2月至2023年5月本院接受膀胱癌手术的105例患者。根据不同的手术治疗方法,将患者分为对照组[n=50例,接受经尿道膀胱肿瘤电切术(TURBT)]和观察组(n=55例,给与HOLRBT)。比较两组患者围手术期指标、临床疗效、术后膀胱肌层获取率、术后膀胱灌注药物使用、术后并发症(膀胱闭孔反射率、膀胱穿孔率)及生活质量。随访1年,记录两组患者术后复发率和生存率。结果:与对照组相比,观察组患者手术持续时间、膀胱冲洗时长、留置尿管时长和术中出血量均减少(均P<0.05)。观察组NMIBC患者的临床疗效为89.09%,高于对照组的72.00%(P<0.05)。观察组患者术后膀胱肌层获取率和术后膀胱灌注药物使用较对照组减少(均P<0.05)。观察组患者术后膀胱闭孔反射率为9.09%,膀胱穿孔率为3.64%,低于对照组的26.00%和18.00%(均P<0.05)。观察组生活质量评分(SF-36)较对照组升高(P<0.05)。随访结果显示,观察组患者1年复发率为12.73%(7/55),低于对照组的30.00%(15/50)(χ^(2)=4.718,P=0.030)。Kaplan-Meier生存曲线表明,观察组患者的生存率高于对照组(87.30%vs 74.00%,Log-rankχ^(2)=4.318,P=0.038)。结论:HOLRBT在NMIBC患者中的预后价值显著,能更有效改善患者术后尿路功能,提升生活质量,降低并发症,具有良好的临床应用前景。Objective:To investigate the impact of transurethral holmium laser enucleation of the bladder tumor(HOLRBT)on postoperative urinary function recovery,quality of life,and prognosis in patients with non-muscle-invasive bladder cancer(NMIBC).Methods:A total of 105 patients who underwent bladder cancer surgery at our hospital from February 2020 to May 2023 were enrolled.Based on the surgical approach,patients were divided into a control group(n=50,transurethral resection of bladder tumor[TURBT])and an observation group(n=55,HOLRBT).Perioperative indicators,clinical efficacy,postoperative bladder muscle layer acquisition rate,postoperative intravesical drug use,complications(bladder obturator reflex rate,bladder perforation rate),and quality of life were compared between the two groups.Patients were followed up for 1 year to record recurrence and survival rates.Results:Compared to the control group,the observation group had shorter surgical duration,bladder irrigation time,and catheter indwelling time,as well as reduced intraoperative blood loss(all P<0.05).The clinical efficacy rate in the observation group was 89.09%,significantly higher than the 72.00%in the control group(P<0.05).The observation group also showed lower postoperative bladder muscle layer acquisition rates and reduced intravesical drug use(both P<0.05).The bladder obturator reflex rate(9.09%vs 26.00%)and bladder perforation rate(3.64%vs 18.00%)were significantly lower in the observation group(all P<0.05).Quality of life scores(SF-36)were higher in the observation group(P<0.05).At 1-year follow-up,the recurrence rate in the observation group was 12.73%(7/55),significantly lower than the 30.00%(15/50)in the control group(χ^(2)=4.718,P=0.030).Kaplan-Meier survival analysis indicated a higher 1-year cumulative survival rate in the observation group(87.30%vs 74.00%,Log-rankχ^(2)=4.318,P=0.038).Conclusion:HOLRBT demonstrates significant prognostic value in NMIBC patients,effectively improving postoperative urinary function,enhancing quality of life,and r

关 键 词：经尿道钬激光剜除术 非肌层浸润性膀胱癌 尿路功能恢复 生活质量 

分 类 号：R73[医药卫生—肿瘤]