本文選題：非肌層浸潤性膀胱腫瘤　切入點：膀胱腫瘤　出處：《新疆醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：系統(tǒng)評價2μm激光與經(jīng)尿道膀胱腫瘤電切術(transurethral resection of bladder tumor,TURBt)治療非肌層浸潤性膀胱腫瘤(non muscle-invasive bladder tumor; NMIBT)的療效差別,為臨床應用提供循證依據(jù)。方法：計算機檢索PubMed, Ovid, Medline、EMbase、 Cochrane Library、CBM、CNKI、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫、超星數(shù)據(jù)庫,同時輔以手工及其他檢索,檢索時間從建庫截止于2013年9月30日,查找所有比較2μm激光與經(jīng)尿道膀胱腫瘤電切術治療非肌層浸潤性膀胱腫瘤的隨機對照試驗研究。按照擬定的納入排除標準篩選文獻、資料提取和方法學質(zhì)量評價后,采用RevMan5.2軟件進行Meta分析。結(jié)果：共納入4個研究全部為RCT,共310例患者,其中2μm激光組161例,TURBt組149例。Meta分析結(jié)果顯示①與TURBt組相比,2μm激光組術后術后留置尿管時間短(MD=1.47,95%CI[-232,-0.62)、膀胱沖洗時間短(SMD=-3.61,95%CI[-4.41,-3.13]),術中、術后膀胱刺激發(fā)生率低(RR=0.30,95%CI[0.19,0.47])、閉孔神經(jīng)反射發(fā)生率低(RR=0.07,95%CI[0.01,0.34])、膀胱穿孔發(fā)生率低(RR=0.09,95%℃CI[0.02,0.45)；②兩種術式在手術時間、術后住院時間、術后尿道狹窄發(fā)生率及術后短期膀胱腫復發(fā)率方面差異無明顯統(tǒng)計學意義。結(jié)論：2μm激光與經(jīng)尿道膀胱腫瘤電切術相比治療非肌層浸潤性膀胱腫瘤療效相當,但術后膀胱沖洗時間、留置尿管時間短,術中、術后膀胱刺激、閉孔神經(jīng)反射、膀胱穿孔發(fā)生率低,因此是一項療效確切,安全性相對較高的微創(chuàng)技術。受納入研究質(zhì)量的限制和可能存在發(fā)表偏倚的影響,上述結(jié)論尚需更多高質(zhì)量隨機對照試驗加以驗證。
[Abstract]:Objective: to evaluate the efficacy of 2 渭 m laser and transurethral resection of bladder tumor TURBt in the treatment of non muscle-invasive bladder tumor (NMIBT). Methods: to provide evidence-based basis for clinical application. Methods: computer search was conducted for PubMed, Ovid, Medline Embase, Cochrane Library CBMN CNKI, Wanfang database, Weip database, superstar database, accompanied by manual and other retrieval. The retrieval time was from September 30th 2013 to September 30th 2013. All randomized controlled trials comparing 2 渭 m laser and transurethral resection of bladder tumors for non-myometrial invasive bladder tumors were studied. RevMan5.2 software was used to analyze Meta. Results: all of the 4 studies were performed in 310 patients. In 2 渭 m laser group, 161 cases of TURBt group (149 cases). Meta-analysis results showed that 1 compared with TURBt group, postoperative indwelling time of urinary catheter in 2 渭 m laser group was shorter than that in 2 渭 m laser group. The duration of indwelling urinary catheter was 1.47% 95 CI [-232 鹵0.62], bladder irrigation time was shorter than that of SMD-3.61 95 CI [-4.41 鹵3.13]. The incidence of postoperative bladder irritation was 0.3095 CI [0.190.47], the incidence of obturator nerve reflex was low, the incidence of bladder perforation was 0.07 ~ 95CI [0.01U 0.34], and the incidence of bladder perforation was 0.0995% CI (0.020.45C CI). There was no significant difference in the incidence of postoperative urethral stricture and the recurrence rate of postoperative short-term bladder tumor. Conclusion compared with transurethral resection of bladder tumor, the curative effect of 2 渭 m laser is comparable to that of transurethral resection of bladder tumor. However, the duration of bladder irrigation after operation, the time of indwelling urethral catheter is short, the rate of bladder stimulation, obturator nerve reflex and bladder perforation is low during the operation, so it is an effective method. Minimally invasive techniques with relatively high safety. These conclusions need to be verified by more high quality randomized controlled trials, which are limited by the quality of inclusion studies and may be subject to publication bias.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R737.14

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