摘要
目的探讨经尿道注射用水膀胱黏膜下注射联合肿瘤电切治疗非肌层浸润性膀胱癌的有效性和安全性。方法将符合入组条件的91例非肌层浸润性膀胱癌患者随机分为处理组46例和对照组45例,处理组先予内镜下注射用水肿瘤基底周围注射,再行肿瘤电切术,对照组采用常规电切术。所有患者术后均予规律膀胱灌注化疗,定期行膀胱镜检查并随访。分析2组患者的临床基本特征及并发症、肿瘤复发情况等。结果2组患者在年龄、性别、肿瘤部位、大小、分期、分级、手术费用等方面比较,差异无统计学意义(P>0.05)。处理组有3例术中发生闭孔神经反射,无膀胱穿孔和输血患者,对照组有5例发生闭孔神经反射,1例因膀胱穿孔行开放手术修补,1例因贫血术后输血,组间差异无统计学意义(P>0.05)。术后3个月,处理组有2例复发,对照组有6例复发,差异无统计学意义(P>0.05);术后6个月,处理组有6例复发,对照组有15例复发,差异有统计学意义(P<0.05);术后12个月时,有7例患者失访(处理组2例、对照组5例),处理组患者有7例复发,对照组中有17例复发,差异有统计学意义(P<0.05)。结论内镜下注射用水膀胱黏膜下注射联合肿瘤电切治疗非肌层浸润性膀胱癌操作安全,并发症少,肿瘤复发率低。
Objective To investigate the efficacy and safety of transurethral bladder submucosal injection of water for injection(WFI)combined with tumor resection in treating non-muscle invasive bladder cancer(NMIBC).Methods A total of 91 non-muscle invasive bladder cancer patients meeting the inclusion criteria were randomly divided into treatment group and control group,with 45 cases per group.The treatment group underwent endoscopic injection of WFI around the tumor base whereas the control group was given routine electrotomy.All patients underwent regular intravesical instillation chemotherapy,routine cystoscopy and follow-up.The clinical basic characteristics,complications,and tumor recurrence were compared between the two groups.Results There were no significant differences in age,gender,tumor site,size,staging,grading,and surgical costs between the two groups(P>0.05).There were 3 cases with obturator nerve reflex in treatment group,no perforation of bladder or anemia occurred. Therewere 5 cases with obturator nerve reflex in thecontrol group, 1 case with bladder repair surgery due to perforation, and 1 case with blood transfusion due to anemia. The difference was not statistically significant ( P >0.05). There were 2 cases with recurrence in treatment group, and 6 cases in the control group at 3 months after surgery, showing no significant difference( P >0.05). The treatment group had more recurrence patients than the control group at 6 months after surgery (15 vs. 6, P <0.05). At 12 months after surgery, 7 patients were lost in follow-up, including 2 in the treatment group and 5 in the control group, and the treatment group had more recurrence patients than the control group(17 vs 7, P <0.05). Conclusion Endoscopic submucosal injection of WFI combined with tumor resection for NMIBC is safe, with less complications and lower recurrence rate.
作者
杨超
王恒兵
牛晓兵
常新
唐静
王功成
刘坤
孟俊嵩
徐宗源
杨晓松
候佩金
傅广波
YANG Chao;WANG Hengbing;NIU Xiaobing;CHANG Xin;TANG Jing;WANG Gongcheng;LIU Kun;MENG Junsong;XU Zongyuan;YANG Xiaosong;HOU Peijin;FU Guangbo(Department of Urology,The Affiliated Huaian First People′s Hospital of Nanjing Medical University,Huai′an,Jiangsu,223300;Department of Ultrasound,The Affiliated Huaian First People′s Hospital of Nanjing Medical University,Huai′an,Jiangsu,223300)
出处
《实用临床医药杂志》
CAS
2019年第22期1-4,共4页
Journal of Clinical Medicine in Practice
基金
江苏省淮安市自然科学基金(HAB201801)
江苏省淮安市科技国际合作促进项目(HAC201708)
关键词
非肌层浸润性膀胱癌
黏膜下注射
注射用水
经尿道膀胱肿瘤电切术
B超
non-muscle invasive bladder cancer
submucosal injection
water for injection
transurethral resection of bladder tumors
B ultrasound
