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目的:探讨2μm激光汽化切除术治疗浅表性膀胱多发肿瘤的安全性及疗效。方法:浅表性膀胱多发肿瘤患者共86例,肿瘤数目为3至8个,肿瘤直径0.5至3.5cm不等,全部肿瘤均为膀胱尿路上皮癌,病理分级为G1至G2,临床分期为Ta、T1。应用2μm激光汽化切除系统,对膀胱肿瘤给予汽化切除。术后常规行膀胱灌注治疗,并定期行膀胱镜检查。结果:所有病例均手术成功,术中出血<20ml,手术时间30至165min。所有患者均未输血,无闭孔神经反射、膀胱穿孔、尿外渗等发生。术后4例患者出现继发性出血,保守治疗后出血停止。术后7至9天拔除尿管,所有患者排尿情况良好。术后随访6至24个月,27例发生肿瘤复发,无尿道狭窄等并发症发生。结论:2μm激光汽化切除术是治疗浅表性膀胱多发肿瘤一种安全、有效的方法。
Objective: To investigate the safety and efficacy of 2 μm laser vaporization in the treatment of superficial multiple bladder tumors. Methods: A total of 86 cases of superficial bladder multiple tumor patients, the number of tumors was 3 to 8, the tumor diameter ranging from 0.5 to 3.5cm, all tumors were bladder urothelial carcinoma, pathological grading G1 to G2, the clinical stage was Ta, T1. The application of 2μm laser vaporization excision system, to give the bladder tumor vaporization. Postoperative routine bladder irrigation treatment, and regular cystoscopy. Results: All the cases were operated successfully. The intraoperative bleeding was less than 20ml and the operation time was 30 to 165 minutes. All patients had no blood transfusion, no obturator nerve reflex, bladder perforation, urine extravasation and so on. Postoperative four patients had secondary bleeding, bleeding stopped after conservative treatment. 7 to 9 days after removal of the catheter, all patients with good urination. All patients were followed up for 6 to 24 months. Twenty-seven patients had recurrence of tumor and no complications such as urethral stricture occurred. Conclusion: 2μm laser vaporization resection is a safe and effective method to treat superficial bladder multiple tumor.