摘要
目的比较原发性非肌层浸润性膀胱癌的激光整块切除与经尿道双极等离子电切术的疗效及对患者血流动力学指标的影响。方法选取我院2017年1月-2020年7月收治的60例原发性非肌层浸润性膀胱癌患者,随机将分为观察组与对照组,每组30例。对照组行双极等离子电切术,观察组行钬激光整块切除术,比较两组患者手术时间、膀胱冲洗时间、术中出血量、不同时间点SVV、SVI、CI、MAP、HR相关血流动力学指标、生存率、局部复发率及并发症发生情况。结果两组手术时间比较,差异无统计学意义(P>0.05);观察组膀胱冲洗时间、住院时间和术中出血量低于对照组,差异有统计学意义(P<0.05);两组手术中SVI、MAP及术后HR比较,差异有统计学意义(P<0.05);两组患者1年生存率及局部复发率比较,差异无统计学意义(P>0.05),观察组2年、3年、5年生存率高于对照组,局部复发率低于对照组(P<0.05);观察组并发症发生率为13.33%,低于对照组的43.33%,差异有统计学意义(P<0.05)。结论对原发性非肌层浸润性膀胱癌患者分别应用钬激光整块切除术能够优化患者手术指标,稳定血流动力学指标,提升患者远期生存率,减少复发情况,安全性好,值得应用。
Objective To compare the efficacy of laser en bladder resection and transurethral bipolar plasma resection of primary non-muscular invasive bladder cancer and their influence on the hemodynamic parameters of patients.Methods A total of 60 patients with primary non-muscular invasive bladder cancer admitted to our hospital from January 2017 to July 2020 were selected and randomly divided into observation group and control group,with 30 cases in each group.The control group underwent bipolar plasma resection,and the observation group underwent holmium laser en bloc resection.The operation time,bladder irrigation time,intraoperative blood loss,SVV,SVI,CI,MAP,HR related blood at different time points were compared between the two groups.Flow dynamics index,survival rate,local recurrence rate and complications.Results There was no significant difference in operation time between the two groups(P>0.05);The bladder irrigation time,hospitalization time and intraoperative blood loss in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05);The comparison of SVI,MAP and postoperative HR between the two groups was statistically significant(P<0.05);There was no significant difference in the 1year survival rate and local recurrence rate between the two groups of patients(P>0.05).The 2 years,3 years,5 years survival rate of observation group was higher than control group,local recurrence rate was lower than control group(P<0.05);The incidence of complications in the observation group was 13.33%,which was lower than 43.33%in the control group,the difference was statistically significant(P<0.05).Conclusion Holmium laser whole block resection for primary non-myometrial invasive bladder cancer can optimize the surgical index,stabilize hemodynamic index,improve the long-term survival rate,reduce recurrence,and be safe.It is worth applying.
作者
许鑫
XU Xin(Department of Urology,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)
出处
《医学信息》
2021年第13期88-91,共4页
Journal of Medical Information
