發(fā)布時間：2018-03-03 13:12

  本文選題：非肌層浸潤性膀胱癌　切入點：二次電切　出處：《山西醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:綜合評價二次電切和單次電切治療非肌層浸潤性膀胱癌的臨床療效,為指導臨床治療非肌層浸潤性膀胱癌選擇更合理的治療方案。方法:本課題在廣泛搜索文獻的基礎上,對已發(fā)表的臨床對照試驗進行Meta分析。通過計算機搜索國外數(shù)據(jù)庫如PubMed、The Cochrane Library、EMbase及國內數(shù)據(jù)庫包括維普數(shù)據(jù)庫、中國知網(wǎng)、萬方數(shù)據(jù)庫。時間為從1994年1月至2016年7月間外科手術治療非肌層浸潤性膀胱癌的臨床對照研究。由兩位研究人員各自獨立搜索文獻并根據(jù)已制定的納入和排除標準篩選文獻,按制定標準篩取文獻資料行Meta分析。結果:結果初步共檢索出488篇文獻,最后納入13篇臨床對照實驗,總共有1928例患者的資料進行Meta分析,其中實驗組(二次電切)共有819例,對照組(單次電切)有1109例。經(jīng)過對納入文獻的資料進行數(shù)據(jù)提取整合并進行Meta分析結果顯示:術后腫瘤復發(fā)率二次電切組(21.8%)低于單次電切組(44.1%),[OR=0.30,95%CI(0.21,0.43),P0.00001],差異有統(tǒng)計學意義;對于術后腫瘤進展率,二次電切組(5.2%),低于未行二次電切術組(13.8%),[OR=0.44,95%CI(0.24,0.80),P=0.007],差異有統(tǒng)計學意義;手術時間,兩種方式?jīng)]有明顯差異,[MD=-9.56,95%CI(-20.6,1.48),P=0.09];留置尿管時間上也沒有顯著差異,[MD=-1.22,95%CI(-2.72,0.28),P=0.11];手術并發(fā)癥,[OR=1.51,95%CI(0.95,2.40),P=0.08],P0.05,差異無統(tǒng)計學意義。結論:相對于單次電切術,二次電切術在腫瘤復發(fā)率和腫瘤進展率均較低,差異有統(tǒng)計學意義;且在手術時間和留置尿管時間、手術并發(fā)癥上與單次電切無明顯差異,值得臨床推廣。
[Abstract]:Objective: to evaluate the clinical efficacy of secondary electroresection and single electroresection in the treatment of non-myometrial invasive bladder cancer. In order to guide clinical treatment of non-myometrial invasive bladder cancer, a more reasonable treatment scheme was selected. Meta analysis of published clinical controlled trials was carried out. Foreign databases such as the Cochrane Library EMbase were searched by computer. Wanfang database. Clinical controlled study of surgical treatment of non-myometrial invasive bladder cancer from January 1994 to July 2016. The two researchers independently searched the literature and screened the literature according to the established inclusion and exclusion criteria. Results: a total of 488 literatures were preliminarily retrieved and 13 clinical controlled trials were conducted. A total of 1 928 patients were analyzed by Meta, including 819 patients in the experimental group (secondary electrotomy). There were 1109 cases in the control group (single electrotomy). The results of data extraction and Meta analysis showed that the recurrence rate of tumor in the secondary resection group was lower than that in the single electroresection group (P 0.00001), and the difference was statistically significant. The rate of tumor progression in the secondary electroresection group was significantly lower than that in the non-secondary electroresection group (13.8%, 0.24% 0.80% P 0.007), and there was a significant difference in the operation time, and the operative time was significantly lower than that in the second electroresection group (P 0.007), and the operative time was significantly lower than that in the second electroresection group (P 0.007, 0.24%, 0.24%, P 0.007). There was no significant difference between the two methods [MD-9.56-95CI-20.61.48P0.09]; there was no significant difference in the time of indwelling urethral catheter [MD-1.2295CI-2.72CI-2.72CI-2.72CI-0.28P0.11]; the complications of operation, [OR1.5195CI0.952.40CI0.952.40CI0.952.40] P0.05, had no statistical significance. Conclusion: compared with single electroresection, the rate of tumor recurrence and tumor progression of two electrosurgical procedures is lower. The difference was statistically significant, and there was no significant difference between the operative time and the time of indwelling urethral catheter, the complications of operation and single electroresection, so it is worth popularizing in clinic.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.14

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