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目的:比较经尿道膀胱肿瘤推切术(简称推切术)与经尿道膀胱肿瘤普通电切术(transurethral resection of bladder tumor,TURBT)治疗非肌层浸润性膀胱癌(non-muscle-invasive bladder cancer,NMIBC)的有效性与安全性。方法:回顾性分析2010年2月~2012年10月收治的NMIBC患者的临床资料,分别选择推切术(n=22,推切术组)与TURBT(n=24,TURBT组)进行治疗,并比较两组手术时间、并发症发生率、术后肉眼血尿及二次经尿道电切术发生率。结果:推切术组手术时间短于TURBT组[(36.5±10.0)min vs(40.9±9.5)min,t=-3.015,P=0.003]。TURBT组术中5例(20.83%)出现闭孔神经反射,高于推切术组(0)(P=0.000)。推切术组术后肉眼血尿时间明显少于TURBT组[(2.3±1.1)d vs(3.0±1.4)d,t=-3.759,P=0.000]。TURBT组术中9例(37.5%)需二次行经尿道电切术,高于推切术组4例(18.18%)(P=0.003)。两组均随访12~32个月,中位数均为18个月,推切术组膀胱肿瘤复发率为22.73%(5/22),TURBT组为29.17%(7/24),差异无统计学意义(log-rankχ2=1.413,P=0.235)。结论:推切术治疗NMIBC具有较高的有效性与安全性,与TURBT相比可缩短手术时间,减少闭孔神经反射,促进术后患者恢复。
Objective: To compare the efficacy and safety of transurethral resection of bladder tumor (TURBT) in the treatment of non-muscle-invasive bladder cancer , NMIBC) effectiveness and safety. Methods: The clinical data of patients with NMIBC who were admitted from February 2010 to October 2012 were analyzed retrospectively. Thyroidectomy (n = 22, debridement) and TURBT (n = 24, TURBT) The operative time, the incidence of complications, gross hematuria and the incidence of secondary transurethral resection were compared between the two groups. Results: The operation time of the resection group was shorter than that of the TURBT group [(36.5 ± 10.0) min vs (40.9 ± 9.5) min, t = -3.015, P = 0.003]. The obturator reflex was found in 5 cases (20.83%) in the TURBT group, which was higher than that in the debridement group (0) (P = 0.000). The gross hematuria time of the resection group was significantly less than that of the TURBT group [(2.3 ± 1.1) d vs (3.0 ± 1.4) d, t = -3.759, P = 0.000]. In the TURBT group, 9 cases (37.5%) underwent transurethral resection of transurethral resection, which was higher than that of the resection group (18.18%) (P = 0.003). Both groups were followed up for 12 to 32 months with a median of 18 months. The recurrence rate of bladder tumor in the resection group was 22.73% (5/22) and in the TURBT group was 29.17% (7/24), with no statistical difference Significance (log-rankχ2 = 1.413, P = 0.235). CONCLUSION: The curative effect and safety of NMIBC are better than that of TURBT. It can shorten the operation time, reduce obturator nerve reflex and promote the recovery of postoperative patients.