本文關(guān)鍵詞： 經(jīng)尿道膀胱腫瘤切除術(shù) 第二代 980nm 半導(dǎo)體紅激光 非肌層浸潤性膀胱腫瘤　出處：《青海大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討經(jīng)尿道980nm第二代紅激光膀胱腫瘤切除術(shù)(DiLRBT)和經(jīng)尿道膀胱腫瘤電切術(shù)(TURBT)治療非肌層浸潤性膀胱腫瘤(NMIBT)的療效和安全性。材料與方法:收集青海省人民醫(yī)院2014年08月~2015年10月的70例經(jīng)DiLRBT(n=30)或TURBT(n=40)治療的非肌層浸潤性膀胱腫瘤患者的臨床資料。按不同的手術(shù)方式分為DiLRBT組和TURBT組,對兩組患者的手術(shù)時間、術(shù)中出血量、閉孔神經(jīng)反射、膀胱穿孔及尿道狹窄等并發(fā)癥發(fā)生率、術(shù)后留置導(dǎo)尿管時間、術(shù)后住院時間等術(shù)中、術(shù)后情況以及術(shù)后12個月隨訪情況進行比較分析。結(jié)果:兩組患者的年齡、性別等術(shù)前一般情況均無統(tǒng)計學(xué)差異。DiLRBT和TURBT的平均時間分別為(22.4±2.4)分鐘和(30.4±7.9)分鐘(P0.0001),差異有統(tǒng)計學(xué)意義。DiLRBT組患者術(shù)中出血量為(17.5±3.5)ml,明顯低于TURBT組的(26.5±2.5)ml。DiLRBT組0例發(fā)生閉孔神經(jīng)反射,0例發(fā)生膀胱穿孔;TURBT組出現(xiàn)7例閉孔神經(jīng)反射,均發(fā)生于側(cè)壁腫瘤患者,其中1例發(fā)生膀胱穿孔,留置導(dǎo)尿管10天后復(fù)查治愈。DiLRBT組患者術(shù)后0例發(fā)生尿道狹窄,TURBT組發(fā)生2例尿道狹窄,定期擴尿道后治愈。DiLRBT組和TURBT組術(shù)后留置導(dǎo)尿管時間分別為(1.41±0.66)天和(2.62±2.13)天(P=0.0005),差異有統(tǒng)計學(xué)意義。兩組患者的術(shù)后住院天數(shù)分別為(3.65±2.85)天和(3.85±2.59)天,(p=0.7604)差異無統(tǒng)計學(xué)意義。DiLRBT組和TURBT組兩組患者術(shù)后均接受隨訪,每3個月復(fù)查泌尿系彩超,腹部、盆腔CT以及膀胱鏡檢查,共隨訪12個月,兩組患者術(shù)后復(fù)發(fā)率無統(tǒng)計學(xué)差異(P0.05)。結(jié)論:1.與傳統(tǒng)的TURBT術(shù)相比較,DiLRBT治療非肌層浸潤性膀胱腫瘤手術(shù)時間短,術(shù)中出血少,閉孔神經(jīng)反射及膀胱穿孔等并發(fā)癥發(fā)生率低,并且術(shù)后復(fù)發(fā)率未見明顯差異。2.DiLRBT術(shù)可作為治療非肌層浸潤性膀胱腫瘤一種安全可靠的手術(shù)方式。
[Abstract]:Objective: to investigate the efficacy and safety of transurethral 980nm second generation red laser cystectomy and transurethral resection of bladder tumor (TURBTT) in the treatment of non-muscular invasive bladder tumor. From August 2014 to October 2015, 70 patients with non-myometrial invasive bladder tumor treated with DiLRBTN30 or TURBTN 40) were divided into DiLRBT group and TURBT group according to different surgical methods. The operative time, intraoperative blood loss, obturator nerve reflex, bladder perforation and urethral stricture, the time of indwelling catheter, the time of hospitalization, etc. Results: the age of the two groups was compared. There was no statistical difference between the two groups before operation. The average time of Dilbt and TURBT were 22.4 鹵2.4 minutes and 30.4 鹵7.9 minutes, respectively. The difference was statistically significant. The intraoperative bleeding volume of patients in the DiLRBT group was 17.5 鹵3.5ml, which was significantly lower than that in the TURBT group (26.5 鹵2.5ml 路DiLRBT group). There were 7 cases of obturator nerve reflex in TURBT group with bladder perforation. All of them occurred in lateral wall tumor, one of them had bladder perforation. Ten days after indwelling urethral catheter, there were 2 cases of urethral stricture in TURBT group, 0 cases of urethral stricture occurred in TURBT group after 10 days of urethral urethral stricture. The postoperative indwelling time of urethral urethral dilatation group and TURBT group were 1.41 鹵0.66 days and 2.62 鹵2.13 days respectively, the difference was statistically significant. The postoperative hospitalization days of the two groups were 3.65 鹵2.85 days and 3.85 鹵2.59 days, respectively. All the patients in the TURBT group and the TURBT group were followed up after operation. The urography, abdominal, pelvic CT and cystoscopy were reexamined every 3 months and followed up for 12 months. There was no significant difference in the postoperative recurrence rate between the two groups (P 0.05). Conclusion compared with the traditional TURBT procedure, the operation time is shorter, the intraoperative bleeding is less, and the complications such as obturator nerve reflex and bladder perforation are lower. There was no significant difference in postoperative recurrence rate. 2. DiLRBT can be used as a safe and reliable method for the treatment of non-myometrial invasive bladder tumors.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.14

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