经尿道钬激光切除与电切治疗浅表性膀胱癌的疗效对比

摘要

目的:评估经尿道钬激光膀胱肿瘤切除术(HOLBT)治疗浅表性膀胱癌的临床疗效,并与经尿道膀胱肿瘤电切术(TURBT)作比较.方法:根据手术方式的不同,将97例浅表性膀胱癌患者分为HOLBT组49例和TURBT组48例.观察两组患者手术情况、手术前后体内炎症因子水平的变化、并发症发生情况以及术后2年的累积复发情况.结果:HOLBT组术中出血量明显少于TURBT组,留置尿管时间及住院时间显著短于TURBT组(P<0.01).HOLBT组术后白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平明显低于TURBT组,IL-10水平明显高于TURBT组,差异有统计学意义(P<0.01).HOLBT组并发症总发生率为6.12%,2年累积复发率为8.16%;TURBT组并发症总发生率为20.83%,2年累积复发率为22.92%,两组比较差异均有统计学意义(P<0.05).结论:HOLBT治疗浅表性膀胱癌疗效显著,安全性高,不仅对术后炎症因子水平影响小,且有助于降低术后复发率.%Objective:To compare the efficacy of holium laser resection of bladder tumor (HOLBT) and transurethral resection of bladder tumor (TURBT) in the treatment of superficial bladder cancer.Methods:According to different surgical methods,97 patients with superficial bladder cancer were divided into HOLBT group (n=49) and TURBT group (n=48).The surgical conditions,levels of pre-and postoperative inflammatory factors,complications and postoperative 2-year accumulative recurrence rate were all observed in two groups.Results:Compared with TURBT group, intraoperative amount of bleeding decreased obviously,time of indwelling catheter and hospital stays were shorter in HOLBT group (P<0.01).Compared with TURBT group, levels of postoperative interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) reduced significantly,while that of IL-10 increased markedly in HOLBT group (P<0.01).The total incidence of complications and postoperative 2-year accumulative recurrence rate were 6.12%,8.16% in HOLBT group and 20.83%,22.92% in TURBT group,and both significant differences were shown between two groups (P<0.05).Conclusion:HOLBT has significant efficacy and higher safety in the treatment of superficial bladder cancer.It hardly impacts the levels of postoperative inflammatory factors,and is conductive to decreasing postoperative recurrence rate.