本文選題：肌層浸潤(rùn)性膀胱癌 + 經(jīng)尿道電切術(shù)��； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文

【摘要】：背景根治性膀胱切除術(shù)(RC)雖然是治療肌層浸潤(rùn)性膀胱癌(MIBC)的金標(biāo)準(zhǔn),但是其圍手術(shù)期風(fēng)險(xiǎn)較高及術(shù)中風(fēng)險(xiǎn)較大,且術(shù)后尿流改道導(dǎo)致患者生活質(zhì)量明顯下降及護(hù)理不便,進(jìn)而患者保留膀胱的需求明顯增高,這就促進(jìn)了能保全膀胱的微創(chuàng)技術(shù)在治療MIBC的不斷發(fā)展進(jìn)步。目的比較TURBT、PVBT、LRC聯(lián)合化療治療的綜合治療模式治療MIBC的臨床療效。方法選取2009.1至2012.02在新鄉(xiāng)醫(yī)學(xué)院第一、三附屬醫(yī)院泌尿外科就診的101例T2N0-1M0至T3N0-1M0期的MIBC患者,分為TURBT、PVBT、LRC三組,分別42例、31例、28例,比較三組手術(shù)時(shí)間、術(shù)中出血量、住院日及1、2、3、4、5年生存率。結(jié)果1三組研究對(duì)象的年齡、性別、體重指數(shù)(BMI)、TNM分期、腫瘤"g5cm均無統(tǒng)計(jì)學(xué)意義(P0.05)。2 TURBT組手術(shù)耗時(shí)平均(62.74±22.39)min,PVBT組耗時(shí)平均(30.61±10.39)min,LRC組耗時(shí)平均(475.00±62.84)min,LRC組手術(shù)時(shí)間明顯長(zhǎng)于另兩組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3 TURBT組住院日平均(7.19±1.29)d,PVBT組住院日平均(4.19±0.95)d,LRC組住院日平均(30.32±7.05)d,LRC組住院日也明顯比兩組長(zhǎng),3組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。TURBT組術(shù)中出血量平均(51.62±11.74)ml;PVBT組術(shù)中出血量平均(20.65±6.38)ml;LRC組術(shù)中出血量(779.64±122.28)ml;三組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4三組1、2、3、4、5年生存率分別是,TURBT組:88.10%、83.33%、64.29%、52.38%、42.86%,PVBT組:87.10%、74.19%、62.29%、58.06%、48.39%,LRC組:85.71%、75.57%、64.29%、60.71%、50.00%;差異無統(tǒng)計(jì)學(xué)意義(P0.05)。5對(duì)三組患者的5年生存率影響因素分析,組內(nèi)腫瘤直徑≥5cm、T3期差異有統(tǒng)計(jì)學(xué)意義(P0.5),組間差異無統(tǒng)計(jì)學(xué)意義(P0.5)。結(jié)論1 LRC、TURBT、PVBT結(jié)合系統(tǒng)化療在治療MIBC上是可行有效的。2腫瘤≥5cm、T3期是影響患者術(shù)后生存率的重要原因。
[Abstract]:Background although radical cystectomy is the gold standard for the treatment of myometrial invasive bladder cancer, the perioperative risk is higher and the intraoperative risk is higher, and the postoperative urinary tract diversion results in a marked decline in the quality of life and inconvenience in nursing care. In turn, the need for bladder retention is significantly increased, which promotes the development of minimally invasive bladder preservation techniques in the treatment of MIBC. Objective to compare the clinical efficacy of TURBTN PVBTLRC combined with chemotherapy in the treatment of MIBC. Methods from 2009.1 to 2012.02, 101 patients with MIBC from T2N0-1M0 to T3N0-1M0 in Urology Department, first and third affiliated Hospital of Xinxiang Medical College, were divided into three groups, 42 patients were divided into three groups, there were 42 patients with MIBC and 31 patients with MIBC. The time of operation and the amount of intraoperative bleeding were compared among the three groups. Days of hospitalization and 4-and 5-year survival rates of 1? 2? Results 1 the age, sex, BMI and TNM-staging of the three groups were not significantly different from those of the other two groups. The mean operation time of the g5cm group was 62.74 鹵22.39 min. The average time taken was 30.61 鹵10.39 min. The mean operating time was 475.00 鹵62.84 min in the LRC group, which was significantly longer than that in the other two groups. There was significant difference in average hospitalization days of P0.05.3 TURBT group (7.19 鹵1.29 d) and average intraoperative blood loss (51.62 鹵11.74 ml) in TURBT group (30.32 鹵7.05 dLRC group) compared with that in the two groups (P 0.055.TURBT group, P 0.055.TURBT group, mean intraoperative bleeding volume, 51.62 鹵11.74ml / L) respectively, and the difference was also statistically significant compared with that of the two groups (P 0.05.TURBT group, P 0.05.TURBT group). The average intraoperative blood loss in the TURBT group was 51.62 鹵11.74ml / ml. (20.65鹵6.38)ml;LRC緇勬湳涓嚭琛，

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