2016 年第 12 期 第 14 卷

经尿道膀胱肿瘤电切术对膀胱癌患者生存情况及不良反应的影响

作者：

单位：

关键词：经尿道膀胱肿瘤电切术膀胱癌肿瘤标志物

• 摘要：
• 【摘要】目的 探讨经尿道膀胱肿瘤电切术（TURBt）对膀胱癌的治疗效果，分析其安全性和有效性。方法 回顾性分析2009年3月-2014年10月在我院接受治疗的膀胱癌患者的临床资料，根据其手术方式分为膀胱部分切除组和经尿道膀胱肿瘤电切术组。观察两组手术一般情况，比较两组手术后生存率、肿瘤标志物水平和并发症发生率的差别。结果 TURBt组患者手术时间和术后留置导尿时间均较膀胱部分切除组短（t=54.396、10.215，P<0.001），术中出血量较膀胱部分切除组少（t=42.843，P<0.001）；两组患者术后1年和2年生存率无明显差别（χ2=0.212、1.059，P=0.646、0.303）；两组患者手术前的肿瘤标志物水平无差别，术后1年，TURBt组患者的CEA、CA19-9和CA125水平均低于膀胱部分切除组（P<0.05）；TURBt组患者术后6个月和术后1年的IPSS得分低于膀胱部分切除组（t=12.085、24.812，P<0.001），Qmax得分高于膀胱部分切除组（t=-8.895、-4.848，P<0.001）；TURBt组膀胱刺激症、下腹痛和发热发生率明显低于膀胱部分切除组（Χ2=10.383，P=0.001）。结论 经尿道膀胱肿瘤电切术对膀胱癌患者有较好的治疗效果，且对排尿功能影响较小，具有较好的临床应用价值。
• Objective To investigate the therapeutic efficacy of transurethral resection of bladder tumor (TURBt) in the treatment of bladder cancer, and to analyze the safety and efficacy of the method. Methods The clinical data of patients with bladder cancer who received treatment in our hospital from March 2009 to October 2014 were retrospectively analyzed. According to the operation method, it is divided into two groups: partial bladder resection group and transurethral bladder tumor resection group. The groups were observed and compared with the two groups, the survival rate, tumor marker level and complication rate were compared between the two groups. Results Compared with partial cystectomy group short time indwelling TURBt group of patients with operation time and postoperative (t=54.396, 10.215, P<0.001), the amount of intraoperative bleeding compared with partial cystectomy group (t=42.843, P<0.001); Two groups of patients after 1 years and 2 years survival rates were not significantly different (2=0.212, 1.059, P=0.646, 0.303); The level of tumor markers in the two groups were not different. After 1 years, the CEA, CA19-9 and CA125 levels of patients in group TURBt were lower than those in partial bladder resection group (P<0.05); The IPSS scores of patients in group TURBt were lower than those in partial bladder resection group (t=12.085, 24.812, P<0.001) after 6 months and 1 year after surgery, and Qmax score was higher than that of partial bladder resection group (t=-8.895, -4.848, P<0.001). TURBt group of bladder irritation, abdominal pain and fever incidence was significantly lower than that of partial bladder resection group (x 2=10.383, P=0.001). Conclusion Transurethral resection of bladder tumor in patients with bladder cancer has good therapeutic effect, and has little effect on micturition function, which has good clinical application value.