摘要
目的分析经尿道钬激光膀胱肿瘤切除术(HOLRBT)在老年非肌层浸润性膀胱癌(NMIBC)患者中的应用效果。方法选取2020年2月—2023年6月该院收治的150例老年NMIBC患者为研究对象,按随机数字表法将其分为对照组和观察组,各75例。对照组行经尿道膀胱肿瘤电切除,观察组行HOLRBT,术后持续观察1个月。对比两组手术情况、肿瘤相关因子水平、排尿功能、并发症发生情况。结果观察组手术时间为(22.31±1.59)min、尿管留置时间为(2.36±0.43)d、住院时间时间为(3.41±0.54)d,均短于对照组的(29.84±2.36)min、(4.72±0.71)d、(5.98±1.01)d,并发症发生率为4.00%,低于对照组的13.33%,组间差异有统计学意义(P<0.05)。术前,两组血管内皮生长因子(VEGF)、肿瘤特异性生长因子(TSGF)、胰岛素样生长因子-1(IGF-1)、尿核基质蛋白22(NMP22)、最大尿流率、最大逼尿肌压力、膀胱顺应性相比,组间差异无统计学意义(P>0.05);术后,观察组VEGF为(48.31±5.19)ng/mL、TSGF为(72.69±6.25)U/mL、IGF-1为(2.59±0.42)ng/mL、NMP22为(1.53±0.54)U/mL,均低于对照组的(71.46±7.20)ng/mL、(84.21±8.36)U/mL、(3.14±0.63)ng/mL、(3.26±0.78)U/mL,最大尿流率为(22.61±4.05)mL/s、最大逼尿肌压力为(23.41±3.14)cmH_(2)O(1 cmH_(2)O=0.098 kPa)、膀胱顺应性为(25.26±3.97)mL/cmH_(2)O,均高于对照组的(17.69±3.47)mL/s、(14.67±2.30)cmH_(2)O、(19.78±3.15)mL/cmH_(2)O,组间差异有统计学意义(P<0.05)。结论HOLRBT具有创伤小、术后恢复快等优势,能够降低老年NMIBC患者肿瘤相关因子水平,改善排尿功能,且并发症少。
Objective To analyze the effect of transurethral holmium laser resection of bladder tumor(HOLRBT)in elderly patients with non muscle invasive bladder cancer(NMIBC).Methods 150 elderly NMIBC patients admitted to the hospital from February 2020 to June 2023 were selected as research objects and randomly divided into a control group and an observation group,with 75 patients in each group.The control group underwent transurethral resection of bladder tumors(TURBT),while the observation group underwent HOLRBT,with continuous observation for 1 month after surgery.Compare the surgical conditions,tumor related factor levels,urination function,and complications between the two groups.Results The results showed that the operating time of the observation group was(22.31±1.59)min,the indwelling time of the urinary catheter was(2.36±0.43)d,and the hospitalization time was(3.41±0.54)d,which was shorter than the control group's(29.84±2.36)min,(4.72±0.71)d,and(5.98±1.01)d;the incidence of complications was 4.00%,which was lower than the control group's 13.33%,and the differences between groups were statistically significant(P<0.05).Before surgery,there was no statistically significant difference between the two groups in terms of vascular endothelial growth factor(VEGF),tumor specific growth factor(TSGF),insulin-like growth factor-1(IGF-1),urinary nuclear matrix protein 22(NMP22),maximum urine flow rate,maximum detrusor pressure,and bladder compliance(P>0.05).After surgery,the observation group had(48.31±5.19)ng/mL of VEGF,(72.69±6.25)U/mL of TSGF,(2.59±0.42)ng/mL of IGF-1,and(1.53±0.54)U/mL of NMP22,which were lower than the control group's(71.46±7.20)ng/mL,(84.21±8.36)U/mL,(3.14±0.63)ng/mL,and(3.26±0.78)U/mL,with a maximum urine flow rate of(22.61±4.05)mL/s and a maximum detrusor pressure of(23.41±3.14)cmH_(2)O;the maximum urinary flow rate was(22.61±4.05)mL/s,the maximum detrusor pressure was(23.41±3.14)cmH_(2)O(1 cmH_(2)O=0.098 kPa),the bladder compliance was(25.26±3.97)mL/cmH_(2)O in the observation group,which were higher than the control group's(17.69±3.47)mL/s,(14.67±2.30)cmH_(2)O,and(19.78±3.15)mL/cmH_(2)O,with statistically significant differences between the groups(P<0.05),Conclusion HOLRBT has the advantages of minimal trauma and fast postoperative recovery,which can reduce the levels of tumor related factors,improve urination function,and have fewer complications in elderly NMIBC patients.
作者
高茂
李国斌
徐国政
谌华根
夏天成
倪娟
GAO Mao;LI Guobin;XU Guozheng;CHEN Huagen;XIA Tiancheng;NI Juan(Department of Urology,Wuxi Eighth People's Hospital,Wuxi Jiangsu,214001,China)
出处
《反射疗法与康复医学》
2023年第18期125-127,131,共4页
Reflexology And Rehabilitation Medicine
关键词
非肌层浸润性膀胱癌
经尿道钬激光膀胱肿瘤切除术
经尿道膀胱肿瘤电切除
排尿功能
并发症
Non muscle invasive bladder cancer
Transurethral holmium laser resection of bladder tumor
Transurethral resection of bladder tumors
Urinary function
Complications
作者简介
高茂(1977-),男,江苏无锡人,硕士研究生,副主任医师,研究方向:腔内泌尿外科疾病诊治及泌尿系结石的微创治疗。
