摘要
目的探讨经尿道膀胱肿瘤绿激光汽化联合术中黏膜下多点注射吉西他滨治疗非肌层浸润性膀胱癌的临床疗效及预后。方法选取2012年3月-2013年11月收治的105例非肌层浸润性膀胱癌患者，采用简单随机分组的方式，经尿道绿激光汽化结合术中黏膜下注射吉西他滨（经尿道绿激光汽化组）38例、经尿道膀胱肿瘤电切术联合术中黏膜下注射吉西他滨（经尿道膀胱肿瘤电切术组）25例、经尿道膀胱肿瘤电切术联合术后即刻膀胱灌注吉西他滨（对照组）42例。采用电话结合门诊随访方式，随访时间为2年，对3种治疗方式的疗效及预后进行比较，并对3组患者治疗后的生活质量做出评价。结果105例患者手术均成功，31例复发，其中经尿道绿激光汽化组7例（18．4％）、经尿道膀胱肿瘤电切术组6例（24％）、对照组18例（42．9％）。3组在原手术区域肿瘤复发率分别为2．6％、8％、19．0％，首例出现肿瘤进展的时间为12个月、10个月、6个月，无进展生存率分别为94．7％（36／38）、92％（23／25）、83．3％（35／42）。3组患者治疗后的躯体功能、心理功能、社会功能、物质生活4个维度的得分差异无统计学意义（P〉0．05）。结论经尿道绿激光汽化结合术中黏膜下多点注射吉西他滨治疗非肌层浸润性膀胱癌，操作简单、安全、并发症少，有效降低了肿瘤复发率，值得在临床上推广应用。
Objective The clinical effect and prognosis of greenlight photoselective laser vaporization combined with intraoperative submueosa multi-point injection of gemcitabin for the treatment of non muscle-invasive bladder tumors（NMIBC）. Methods Selected 105 cases of NMIBC Confirmed by pathology from Mar. 2012 to Nov. 2013 in Guangzhou General Hosptial of Guangzhou Military Command of PLA urology. Put the patients into three groups randomly. Greenlight photoselective laser vaporization for bladder tumors （PVBT） combined with intraoperative submueosal injection of gemeitabine （ PVBT group） 38 cases, Transurethral resection of bladder tumor （TURBT） com- bined with intraoperative submueosal injection of gemcitabine 25 cases （ TURBT group） , TURBT combined with im- mediate postoperative bladder perfusion chemotherapy （ Control group ） 42 cases. Maintain the bladder perfusion chemotherapy after surgery, follow-up of 2 years. To compare and analysis the effect and the prognosis of three ways of operation method, And evaluate the quality of life of three groups of patients after treatment. Results The oper- ation of 105 cases were successful, a total of 31 cases of recurrence, included PVBT group 7 cases （ 18.4% ） , TURBT group 6 cases （24%）, contrlol group 18 cases （42.9%）. Tumor progression of time were 12,10,6 month for the first time. The body function, psychological function, social function and material life of four dimensions scores have no obvious difference Three groups （ P 〉 0.05 ）. Conclusions PVBT combined with intraoperative submucosal muhi-point injection of gemcitabine is a kind of simple operation, and reduce the complications and the recurrence of the operation, especially suitable for the lateral wall of superficial tumor and intolerance to TURBT surgery for high-risk patients. It is a new better method of expansion clinical application.
出处
《国际外科学杂志》
2016年第2期107-112,F0004,共7页
International Journal of Surgery
关键词
膀胱肿瘤
绿激光膀胱肿瘤汽化术
膀胱肿瘤电切术
注射
吉西他滨
复发
Urinary bladder neoplasms
Green laser photoselective vaporization of bladder tumor
Transurethral resection of bladder tumor
Injections
Gemcitabin
Recurrence
