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目的:评价TURBt联合术前髂内动脉化疗栓塞术治疗直径≥3cm的肌层浸润性膀胱癌的临床效果。方法:将45例直径≥3cm的肌层浸润性膀胱癌患者(分期:T2~3N0M0)分为A、B两组,A组23例,单纯行TURBt,B组22例,行TURBt联合术前髂内动脉化疗栓塞。统计分析比较两组手术时间、出血量、生存率、复发率、不良反应发生率,并绘制生存曲线及复发率曲线。结果:A组手术时间为(61.2±8.3)min,出血量(55.8±3.7)ml,B组手术时间为(30±8.4)min,出血量(20.3±5.4)ml,两组比较差异有统计学意义(P<0.05)。3年生存率,A组为86.36%,B组为95.00%,两组比较差异无统计学意义(P>0.05)。3年复发率,A组为54.55%,B组为45%,两组比较差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:TURBt术前髂内动脉化疗栓塞治疗直径≥3cm的肌层浸润性膀胱癌有效降低了手术难度及术后复发率,近期效果满意。
Objective: To evaluate the clinical effect of TURBt combined with preoperative internal iliac artery chemoembolization in the treatment of myometrial invasive bladder cancer with diameter ≥3cm. Methods: Forty-five patients with invasive bladder cancer with a diameter of more than 3 cm (stage: T2 ~ 3N0M0) were divided into two groups: A and B, 23 cases in group A, TURBt in group B and 22 cases in group B. TURBt combined with preoperative Internal iliac artery chemoembolization. Statistical analysis was performed to compare the operation time, blood loss, survival rate, recurrence rate and incidence of adverse reactions in the two groups. The survival curves and recurrence rate curves were drawn. Results: The operation time in group A was (61.2 ± 8.3) min and the amount of bleeding was (55.8 ± 3.7) ml. The operation time in group B was (30 ± 8.4) min and the amount of bleeding was (20.3 ± 5.4) Significance (P <0.05). The 3-year survival rate was 86.36% in group A and 95.00% in group B, with no significant difference between the two groups (P> 0.05). The recurrence rate in 3 years was 54.55% in group A and 45% in group B, with significant difference between the two groups (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion: TURBt preoperative treatment of internal iliac artery chemoembolization for the treatment of invasive bladder cancer with a diameter of more than 3cm effectively reduces the difficulty of operation and postoperative recurrence rate, with satisfactory results in the near future.