發(fā)布時(shí)間：2018-03-18 07:47

  本文選題：非肌層浸潤(rùn)性膀胱癌　切入點(diǎn)：經(jīng)尿道膀胱腫瘤切除術(shù)　出處：《山西醫(yī)科大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:利用meta分析的優(yōu)勢(shì),更加高效客觀的評(píng)價(jià)綠激光選擇性膀胱腫瘤汽化術(shù)(PVBT)與經(jīng)尿道膀胱腫瘤切除術(shù)(TURBT)治療非肌層浸潤(rùn)性膀胱腫瘤(NMIBC)的術(shù)后療效及手術(shù)的安全性。方法:選取發(fā)表于國(guó)內(nèi)外核心期刊上的2006~2015年的文獻(xiàn),對(duì)比PVBT與TURBT兩種術(shù)式治療的NMIBC的臨床對(duì)照試驗(yàn),嚴(yán)格按照納入排除標(biāo)準(zhǔn)提取相關(guān)指標(biāo)數(shù)據(jù),并應(yīng)用Meta分析的方法評(píng)價(jià)手術(shù)的安全性及術(shù)后療效。結(jié)果:最終共有14篇文獻(xiàn)符合納入標(biāo)準(zhǔn),總研究樣本量1680例,PVBT組761例,TURBT組919例。Meta分析結(jié)果:PVBT組比TURBT組術(shù)后復(fù)發(fā)率低[OR 0.39,95%CI0.27-0.56,P0.0001]。PVBT組與TURBT組兩種術(shù)式手術(shù)時(shí)間無(wú)明顯差別[p0.05]。PVBT組術(shù)后住院時(shí)間比TURBT組短[SMD-2.53 d,95%CI-3.61-(-1.44)d,P0.0001]。PVBT組手術(shù)出血量比TURBT組少[SMD-18.16 ml,95%CI-19.65-(-16.66)ml,P0.0001]。PVBT組術(shù)后尿管留置時(shí)間比TURBT組短[SMD-2.60 d,95%CI-3.42-(-1.77)d,P0.0001]。PVBT組術(shù)后膀胱沖洗時(shí)間比TURBT組短[SMD-1.23,95%CI-1.35-(-1.12),P0.0001]。PVBT組手術(shù)并發(fā)癥發(fā)生率比TURBT低[OR 0.06,95%CI 0.03-0.12,p0.0001]。結(jié)論:對(duì)于NMIBC的治療,PVBT術(shù)較TURBT術(shù)不會(huì)增加手術(shù)時(shí)間,并且表現(xiàn)出在手術(shù)安全性指標(biāo)較經(jīng)典的TURBT術(shù)式有一定優(yōu)勢(shì),更為重要的是,PVBT術(shù)可能會(huì)有助于降低NMIBC術(shù)后的復(fù)發(fā)率。
[Abstract]:Objective: to utilize the advantage of meta analysis, To evaluate the efficacy and safety of green laser selective vaporization of bladder tumor (PVBT) and transurethral resection of bladder tumor (TURBT) in the treatment of non-muscular invasive bladder tumor. The literature from 2006 to 2015 in internal and external core journals, The clinical controlled trials of NMIBC treated with PVBT and TURBT were compared, and the relevant index data were extracted strictly according to the inclusive exclusion criteria. Meta analysis was used to evaluate the safety and efficacy of the operation. Results: a total of 14 articles met the inclusion criteria. The results of Meta-analysis showed that the recurrence rate of TURBT group was lower than that of TURBT group [OR 0.3995 CI0.27-0.56P 0.0001] .There was no significant difference between PVBT group and TURBT group. The postoperative hospitalization time of PVBT group was shorter than that of TURBT group [SMD-2.53 d95CI-3.61-1.44d#en0# P0.0001]. The postoperative urinary catheter retention time in the PVBT group was shorter than that in the TURBT group [SMD-2.60 d95CI-3.42-1.77dP0.0001]. The postoperative bladder irrigation time in the PVBT group was shorter than that in the TURBT group [SMD-1.2395CI-1.35-P0.0001]. The incidence of postoperative complications in the PVBT group was lower than that in the TURBT group [OR 0.0695 CI 0.03-0.12p 0.0001]. Conclusion: the duration of postoperative bladder irrigation in the PVBT group is not longer than that in the TURBT group [SMD-1.2395CI-1.35-P0.0001]. The incidence of postoperative complications in the PVBT group is lower than that in the TURBT group [OR 0.0695 CI 0.03-0.12p 0.0001]. The results also showed that there were some advantages in the safety index of operation compared with the classical TURBT operation, and more importantly, it might be helpful to reduce the recurrence rate of NMIBC.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R737.14

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