本文選題：肌層浸潤(rùn)性膀胱癌　切入點(diǎn)：膀胱部分切除術(shù)　出處：《延邊大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:評(píng)價(jià)兩種保留膀胱的不同手術(shù)方式治療肌層浸潤(rùn)性膀胱癌的臨床療效,探討兩種術(shù)式對(duì)預(yù)后的影響因素。方法:收集2009年1月至2013年10月在延邊大學(xué)附屬醫(yī)院泌尿外科住院的患者,采用經(jīng)尿道膀胱腫瘤電切術(shù)(Transurethral resection of bladder tumor,TURBT)和膀胱部分切除術(shù)(Partial cystectomy,PC)治療肌層浸潤(rùn)性膀胱癌(muscle-invasive bladder cancer,MIBC)病例共 84 例,分為 PC 組49 例(T231 例,T314例,T44例)和 TURBT 組 35 例(T231 例,T34 例,T40 例)。全部患者進(jìn)行術(shù)后隨訪3年。比較2種手術(shù)方式、手術(shù)時(shí)間、術(shù)中出血量、留置導(dǎo)尿管時(shí)間、住院時(shí)間、并發(fā)癥和3年復(fù)發(fā)率,并分析兩種手術(shù)方式與生存相關(guān)的預(yù)后因素。結(jié)果:PC組與TURBT組患者平均住院日期、手術(shù)時(shí)間、術(shù)中出血量及留置導(dǎo)尿管時(shí)間均有的統(tǒng)計(jì)學(xué)差異(均P0.05),而并發(fā)癥及3年復(fù)發(fā)率無(wú)統(tǒng)計(jì)差異(P0.05)。PC組與TURBT組中與腫瘤生存相關(guān)的獨(dú)立危險(xiǎn)因素是腫瘤的病理分期(B值分別為1.459與1.900)。MIBC與腫瘤生存相關(guān)的獨(dú)立危險(xiǎn)因素為腫瘤的病理分期和腫瘤數(shù)量(B值1.058,1.454);3年隨訪期間PC組和TURBT組死于膀胱癌各為14例(71.4%)和10例(71.4%),兩組T3患者3年腫瘤特異生存率(Cancerspecific survival,CSS)分別為 50%和0%(P=0.036)。結(jié)論:保留膀胱手術(shù)TURBT更適合T2患者,而PC更適合T3-4患者,兩組的腫瘤病理分期是影響預(yù)后的獨(dú)立危險(xiǎn)因素;腫瘤分期越高,手術(shù)危險(xiǎn)性更大,生存率越低;而分期越低,越適合做保留膀胱手術(shù)。
[Abstract]:Objective: to evaluate the clinical efficacy of two different bladder preserving surgical methods in the treatment of myometrial invasive bladder cancer. Methods: from January 2009 to October 2013, we collected the patients hospitalized in the Urology Department of Yanbian University affiliated Hospital. Transurethral resection of bladder tumor TURBT (transurethral resection of bladder tumor TURBT) and partial cystectomy (partial cystectomy) were performed in 84 cases of muscle-invasive bladder carcinoma of bladder cancer. The patients were divided into PC group (n = 49) and TURBT group (n = 35) and TURBT group (n = 35). All patients were followed up for 3 years. The complications and the recurrence rate of 3 years were analyzed, and the prognostic factors related to survival were analyzed. Results the average hospitalization date and operation time of the patients in the TURBT group and the PC group were analyzed. There were statistical differences in intraoperative bleeding volume and indwelling catheter time (all P 0.05), but there was no statistical difference in complications and recurrence rate of 3 years. The independent risk factors related to tumor survival in PC group and TURBT group were the pathological staging and B score of tumor. The independent risk factors related to tumor survival were tumor pathological stage and tumor number (B = 1.058 / 1.454g, respectively, 14 patients died of bladder cancer in PC group and TURBT group (n = 14)) and 10 patients died from bladder cancer (n = 10) and 10 patients in group T _ 3 (n = 10). The tumor was specific for three years in both groups of T3 patients. The survival rate was 50% and 0 respectively. Conclusion: preserving TURBT for bladder surgery is more suitable for T2 patients. PC is more suitable for T3-4 patients. Tumor pathological staging is an independent risk factor for prognosis in both groups. The higher the tumor stage is, the greater the surgical risk is, and the lower the survival rate is; the lower the staging, the more suitable for bladder preservation surgery.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.14

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