DiLRBT与TURBT治疗NMIBT的临床疗效比较

发布时间：2018-02-28 01:13

本文关键词： 经尿道膀胱肿瘤切除术第二代 980nm 半导体红激光非肌层浸润性膀胱肿瘤　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨经尿道980nm第二代红激光膀胱肿瘤切除术(DiLRBT)和经尿道膀胱肿瘤电切术(TURBT)治疗非肌层浸润性膀胱肿瘤(NMIBT)的疗效和安全性。材料与方法:收集青海省人民医院2014年08月~2015年10月的70例经DiLRBT(n=30)或TURBT(n=40)治疗的非肌层浸润性膀胱肿瘤患者的临床资料。按不同的手术方式分为DiLRBT组和TURBT组,对两组患者的手术时间、术中出血量、闭孔神经反射、膀胱穿孔及尿道狭窄等并发症发生率、术后留置导尿管时间、术后住院时间等术中、术后情况以及术后12个月随访情况进行比较分析。结果:两组患者的年龄、性别等术前一般情况均无统计学差异。DiLRBT和TURBT的平均时间分别为(22.4±2.4)分钟和(30.4±7.9)分钟(P0.0001),差异有统计学意义。DiLRBT组患者术中出血量为(17.5±3.5)ml,明显低于TURBT组的(26.5±2.5)ml。DiLRBT组0例发生闭孔神经反射,0例发生膀胱穿孔;TURBT组出现7例闭孔神经反射,均发生于侧壁肿瘤患者,其中1例发生膀胱穿孔,留置导尿管10天后复查治愈。DiLRBT组患者术后0例发生尿道狭窄,TURBT组发生2例尿道狭窄,定期扩尿道后治愈。DiLRBT组和TURBT组术后留置导尿管时间分别为(1.41±0.66)天和(2.62±2.13)天(P=0.0005),差异有统计学意义。两组患者的术后住院天数分别为(3.65±2.85)天和(3.85±2.59)天,(p=0.7604)差异无统计学意义。DiLRBT组和TURBT组两组患者术后均接受随访,每3个月复查泌尿系彩超,腹部、盆腔CT以及膀胱镜检查,共随访12个月,两组患者术后复发率无统计学差异(P0.05)。结论:1.与传统的TURBT术相比较,DiLRBT治疗非肌层浸润性膀胱肿瘤手术时间短,术中出血少,闭孔神经反射及膀胱穿孔等并发症发生率低,并且术后复发率未见明显差异。2.DiLRBT术可作为治疗非肌层浸润性膀胱肿瘤一种安全可靠的手术方式。
[Abstract]:Objective: to investigate the efficacy and safety of transurethral 980nm second generation red laser cystectomy and transurethral resection of bladder tumor (TURBTT) in the treatment of non-muscular invasive bladder tumor. From August 2014 to October 2015, 70 patients with non-myometrial invasive bladder tumor treated with DiLRBTN30 or TURBTN 40) were divided into DiLRBT group and TURBT group according to different surgical methods. The operative time, intraoperative blood loss, obturator nerve reflex, bladder perforation and urethral stricture, the time of indwelling catheter, the time of hospitalization, etc. Results: the age of the two groups was compared. There was no statistical difference between the two groups before operation. The average time of Dilbt and TURBT were 22.4 卤2.4 minutes and 30.4 卤7.9 minutes, respectively. The difference was statistically significant. The intraoperative bleeding volume of patients in the DiLRBT group was 17.5 卤3.5ml, which was significantly lower than that in the TURBT group (26.5 卤2.5ml 路DiLRBT group). There were 7 cases of obturator nerve reflex in TURBT group with bladder perforation. All of them occurred in lateral wall tumor, one of them had bladder perforation. Ten days after indwelling urethral catheter, there were 2 cases of urethral stricture in TURBT group, 0 cases of urethral stricture occurred in TURBT group after 10 days of urethral urethral stricture. The postoperative indwelling time of urethral urethral dilatation group and TURBT group were 1.41 卤0.66 days and 2.62 卤2.13 days respectively, the difference was statistically significant. The postoperative hospitalization days of the two groups were 3.65 卤2.85 days and 3.85 卤2.59 days, respectively. All the patients in the TURBT group and the TURBT group were followed up after operation. The urography, abdominal, pelvic CT and cystoscopy were reexamined every 3 months and followed up for 12 months. There was no significant difference in the postoperative recurrence rate between the two groups (P 0.05). Conclusion compared with the traditional TURBT procedure, the operation time is shorter, the intraoperative bleeding is less, and the complications such as obturator nerve reflex and bladder perforation are lower. There was no significant difference in postoperative recurrence rate. 2. DiLRBT can be used as a safe and reliable method for the treatment of non-myometrial invasive bladder tumors.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.14

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