整块切除术与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱肿瘤的效果比较(1)
[摘要]目的 探討整块切除术治疗非肌层浸润性膀胱肿瘤(NMIBC)的安全性和有效性。方法 回顾性分析我院2015年12月～2019年6月行手术治疗的49例NMIBC患者的临床资料，根据治疗方法不同分为观察组(26例)与对照组(23例)。观察组行经尿道整块切除术治疗，对照组行经尿道膀胱肿瘤电切术(TURBT)治疗。比较两组的手术时间、术中出血量、术后并发症、术后住院时间、住院费用及切缘阳性率等，同时利用抑郁、焦虑自评表比较两组患者治疗4周后的心理评分。结果 两组的手术时间、术后住院时间、住院费用比较，差异均无统计学意义(P>0.05);观察组患者的术中出血量少于对照组，差异有统计学意义(P<0.05);观察组的术后病理切缘阳性率低于对照组，差异有统计学意义(P<0.05);两组患者得膀胱穿孔、闭孔神经反射、术后膀胱刺激症发生率比较，差异无统计学意义(P>0.05);两组患者治疗4周后的抑郁与焦虑心理评分比较，差异无统计学意义(P>0.05)。结论 采用经尿道整块切除术治疗非肌层浸润性膀胱肿瘤，相较于传统TURBT具有术中出血少、术后病理切缘阳性率低等优点，是一种操作简单、安全性高、疗效理想、值得临床推广的治疗方法。
[关键词]非肌层浸润性膀胱肿瘤;整块切除术;经尿道膀胱肿瘤电切术;并发症
[中图分类号] R737.14 [文献标识码] A [文章编号] 1674-4721(2020)7(a)-0125-04
Comparison of therapeutic effect between en bloc enucleation and transurethral resection of bladder tumor in the treatment of non-muscular invasive bladder tumor
CHEN Jian WEI Huai-ying TANG Hua YE De-chuan
Department of Urology， Sanming Second Hospital of Fujian Province the Fifth Clinical Medical College of Fujian University of Traditional Chinese Medicine， Fujian Province， Yong′an 366000， China
[Abstract] Objective To investigate the safety and effectiveness of en bloc enucleation in the treatment of non-muscular invasive bladder tumor (NMIBC). Methods The clinical data of 49 patients with NMIBC who underwent surgical treatment from December 2015 to June 2019 in our hospital were retrospectively analyzed. According to different treatment methods， the patients were divided into the observation group (26 cases) and the control group (23 cases) according to different treatment methods. The observation group was treated by transurethral en bloc enucleation， and the control group was treated with transurethral resection of bladder tumor (TURBT). The operation time， intraoperative hemorrhage， postoperative complications， postoperative hospitalization time， hospitalization cost and the positive rate of the incision base were compared between the two groups. At the same time， the self-assessment of depression and anxiety were used to compare the psychological scores of the two groups after 4 weeks of treatment. Results There were no significant differences between the two groups in operation time， postoperative hospitalization time and hospitalization cost (P>0.05). The intraoperative blood loss of patients in the observation group was less than that in the control group， and the difference was statistically significant (P<0.05). The positive rate of pathological margin basement after operation in the observation group was lower than that of the control group， and the difference was statistically significant (P<0.05); There were no significant difference in the incidence of bladder perforation， obturator nerve reflex and postoperative bladder irritation between the two groups (P>0.05). There were no significant difference in the psychological scores of depression and anxiety between the two groups after 4 weeks of treatment (P>0.05). Conclusion Compared with traditional TURBT， transurethral en bloc enucleation has the advantages of less intraoperative bleeding and lower positive rate of pathological margin after operation. It is a simple， safe， effective treatment method and worthy of clinical promotion., 百拇医药(陈剑 魏怀莹 唐华 叶德川)
[关键词]非肌层浸润性膀胱肿瘤;整块切除术;经尿道膀胱肿瘤电切术;并发症
[中图分类号] R737.14 [文献标识码] A [文章编号] 1674-4721(2020)7(a)-0125-04
Comparison of therapeutic effect between en bloc enucleation and transurethral resection of bladder tumor in the treatment of non-muscular invasive bladder tumor
CHEN Jian WEI Huai-ying TANG Hua YE De-chuan
Department of Urology， Sanming Second Hospital of Fujian Province the Fifth Clinical Medical College of Fujian University of Traditional Chinese Medicine， Fujian Province， Yong′an 366000， China
[Abstract] Objective To investigate the safety and effectiveness of en bloc enucleation in the treatment of non-muscular invasive bladder tumor (NMIBC). Methods The clinical data of 49 patients with NMIBC who underwent surgical treatment from December 2015 to June 2019 in our hospital were retrospectively analyzed. According to different treatment methods， the patients were divided into the observation group (26 cases) and the control group (23 cases) according to different treatment methods. The observation group was treated by transurethral en bloc enucleation， and the control group was treated with transurethral resection of bladder tumor (TURBT). The operation time， intraoperative hemorrhage， postoperative complications， postoperative hospitalization time， hospitalization cost and the positive rate of the incision base were compared between the two groups. At the same time， the self-assessment of depression and anxiety were used to compare the psychological scores of the two groups after 4 weeks of treatment. Results There were no significant differences between the two groups in operation time， postoperative hospitalization time and hospitalization cost (P>0.05). The intraoperative blood loss of patients in the observation group was less than that in the control group， and the difference was statistically significant (P<0.05). The positive rate of pathological margin basement after operation in the observation group was lower than that of the control group， and the difference was statistically significant (P<0.05); There were no significant difference in the incidence of bladder perforation， obturator nerve reflex and postoperative bladder irritation between the two groups (P>0.05). There were no significant difference in the psychological scores of depression and anxiety between the two groups after 4 weeks of treatment (P>0.05). Conclusion Compared with traditional TURBT， transurethral en bloc enucleation has the advantages of less intraoperative bleeding and lower positive rate of pathological margin after operation. It is a simple， safe， effective treatment method and worthy of clinical promotion., 百拇医药(陈剑 魏怀莹 唐华 叶德川)