肌层浸润性膀胱癌三种微创治疗方法的对比观察
发布时间：2018-05-11 06:51
本文选题：肌层浸润性膀胱癌 + 经尿道电切术 ； 参考：《新乡医学院》2017年硕士论文
【摘要】：背景根治性膀胱切除术(RC)虽然是治疗肌层浸润性膀胱癌(MIBC)的金标准,但是其围手术期风险较高及术中风险较大,且术后尿流改道导致患者生活质量明显下降及护理不便,进而患者保留膀胱的需求明显增高,这就促进了能保全膀胱的微创技术在治疗MIBC的不断发展进步。目的比较TURBT、PVBT、LRC联合化疗治疗的综合治疗模式治疗MIBC的临床疗效。方法选取2009.1至2012.02在新乡医学院第一、三附属医院泌尿外科就诊的101例T2N0-1M0至T3N0-1M0期的MIBC患者,分为TURBT、PVBT、LRC三组,分别42例、31例、28例,比较三组手术时间、术中出血量、住院日及1、2、3、4、5年生存率。结果1三组研究对象的年龄、性别、体重指数(BMI)、TNM分期、肿瘤"g5cm均无统计学意义(P0.05)。2 TURBT组手术耗时平均(62.74±22.39)min,PVBT组耗时平均(30.61±10.39)min,LRC组耗时平均(475.00±62.84)min,LRC组手术时间明显长于另两组,差异有统计学意义(P0.05)。3 TURBT组住院日平均(7.19±1.29)d,PVBT组住院日平均(4.19±0.95)d,LRC组住院日平均(30.32±7.05)d,LRC组住院日也明显比两组长,3组差异有统计学意义(P0.05)。TURBT组术中出血量平均(51.62±11.74)ml;PVBT组术中出血量平均(20.65±6.38)ml;LRC组术中出血量(779.64±122.28)ml;三组差异有统计学意义(P0.05)。4三组1、2、3、4、5年生存率分别是,TURBT组:88.10%、83.33%、64.29%、52.38%、42.86%,PVBT组:87.10%、74.19%、62.29%、58.06%、48.39%,LRC组:85.71%、75.57%、64.29%、60.71%、50.00%;差异无统计学意义(P0.05)。5对三组患者的5年生存率影响因素分析,组内肿瘤直径≥5cm、T3期差异有统计学意义(P0.5),组间差异无统计学意义(P0.5)。结论1 LRC、TURBT、PVBT结合系统化疗在治疗MIBC上是可行有效的。2肿瘤≥5cm、T3期是影响患者术后生存率的重要原因。
[Abstract]:Background although radical cystectomy is the gold standard for the treatment of myometrial invasive bladder cancer, the perioperative risk is higher and the intraoperative risk is higher, and the postoperative urinary tract diversion results in a marked decline in the quality of life and inconvenience in nursing care. In turn, the need for bladder retention is significantly increased, which promotes the development of minimally invasive bladder preservation techniques in the treatment of MIBC. Objective to compare the clinical efficacy of TURBTN PVBTLRC combined with chemotherapy in the treatment of MIBC. Methods from 2009.1 to 2012.02, 101 patients with MIBC from T2N0-1M0 to T3N0-1M0 in Urology Department, first and third affiliated Hospital of Xinxiang Medical College, were divided into three groups, 42 patients were divided into three groups, there were 42 patients with MIBC and 31 patients with MIBC. The time of operation and the amount of intraoperative bleeding were compared among the three groups. Days of hospitalization and 4-and 5-year survival rates of 1? 2? Results 1 the age, sex, BMI and TNM-staging of the three groups were not significantly different from those of the other two groups. The mean operation time of the g5cm group was 62.74 卤22.39 min. The average time taken was 30.61 卤10.39 min. The mean operating time was 475.00 卤62.84 min in the LRC group, which was significantly longer than that in the other two groups. There was significant difference in average hospitalization days of P0.05.3 TURBT group (7.19 卤1.29 d) and average intraoperative blood loss (51.62 卤11.74 ml) in TURBT group (30.32 卤7.05 dLRC group) compared with that in the two groups (P 0.055.TURBT group, P 0.055.TURBT group, mean intraoperative bleeding volume, 51.62 卤11.74ml / L) respectively, and the difference was also statistically significant compared with that of the two groups (P 0.05.TURBT group, P 0.05.TURBT group). The average intraoperative blood loss in the TURBT group was 51.62 卤11.74ml / ml. (20.65卤6.38)ml;LRC缁勬湳涓嚭琛，
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