本文選題：膀胱部分切除術(shù) + 根治性膀胱切除術(shù)�。� 參考：《濟(jì)南大學(xué)》2017年碩士論文

【摘要】：目的比較膀胱部分切除術(shù)和根治性膀胱切除術(shù)治療肌層浸潤性膀胱癌的臨床療效,探討膀胱部分切除術(shù)在肌層浸潤性膀胱尿路上皮癌中的應(yīng)用價(jià)值。方法回顧性分析2002年1月-2012年1月山東大學(xué)附屬山東省腫瘤醫(yī)院泌尿外科收治的126例肌層浸潤性膀胱癌(T2-T3)患者的臨床資料,根據(jù)手術(shù)方式的不同,分為膀胱部分切除術(shù)組(A組)和根治性膀胱切除組(B組),統(tǒng)計(jì)分析兩組患者住院時(shí)間、手術(shù)時(shí)間、術(shù)中出血量、1年生存率、3年生存率、5年生存率、患者術(shù)后生活質(zhì)量,及T2、T3期膀胱癌患者部分切除與根治性切除術(shù)后1年生存率、3年生存率、5年生存率,以評價(jià)膀胱部分切除術(shù)在肌層浸潤性膀胱癌中的治療效果。結(jié)果共入組126例,其中A組62例,其中男性55例,女性7例,低級別尿路上皮癌13例,高級別尿路上皮癌49例,年齡在38-75歲之間;B組64例,其中男性51例,女性13例,其中低級別尿路上皮癌14例,高級別尿路上皮癌50例,年齡在36-75歲之間。A組患者術(shù)后1年、3年、5年生存率分別是90.32%,67.74%,46.77%,B組患者術(shù)后1年、3年、5年生存率分別是89.06%,82.81%,65.63%;兩者術(shù)后3、5年生存率差異有統(tǒng)計(jì)學(xué)意義(根治手術(shù)組優(yōu)于部分切除術(shù))。T2期患者行膀胱部分切除術(shù)后1年、3年、5年生存率分別是87.50%,81.25%,62.50%,行膀胱根治性切除術(shù)后1年、3年、5年生存率分別是91.67%,87.50%,70.83%,兩者之間差異均無統(tǒng)計(jì)學(xué)意義,但膀胱部分切除術(shù)手術(shù)時(shí)間短、出血量少、住院時(shí)間短,并且患者生活質(zhì)量明顯優(yōu)于根治術(shù)者。T3期患者行膀胱部分切除術(shù)聯(lián)合術(shù)后化療術(shù)后1年、3年、5年生存率分別是93.33%,53.33%,30.00%,行膀胱根治性切除術(shù)后1年、3年、5年生存率分別是87.50%,80.00%,62.50%,兩者術(shù)后3、5年生存率差異有統(tǒng)計(jì)學(xué)意義。結(jié)論1.對于T2期膀胱癌患者,膀胱部分切除術(shù)1、3、5年生存率與根治術(shù)無差異,但其手術(shù)時(shí)間短、出血量少、住院時(shí)間短,并且患者生活質(zhì)量明顯優(yōu)于根治術(shù),膀胱部分切除術(shù)是可選擇的術(shù)式;2.對于T3膀胱癌,根治性手術(shù)3年、5年生存率高于膀胱部分切除術(shù)。
[Abstract]:Objective to compare the clinical efficacy of partial cystectomy and radical cystectomy in the treatment of myometrial invasive bladder cancer and to explore the value of partial cystectomy in the treatment of myometrial invasive bladder urothelial carcinoma. Methods the clinical data of 126 patients with intramuscular invasive bladder cancer (T2-T3) treated in Department of Urology, Shandong Cancer Hospital affiliated to Shandong University from January 2002 to January 2012 were retrospectively analyzed. Two groups were divided into two groups: partial cystectomy group (group A) and radical cystectomy group (group B). The hospitalization time, operation time, intraoperative bleeding volume, 1 year survival rate, 3 year survival rate, 5 year survival rate and postoperative quality of life were statistically analyzed. In order to evaluate the therapeutic effect of partial cystectomy on invasive bladder cancer, 1 year survival rate, 3 year survival rate and 5 year survival rate after partial resection and radical resection were evaluated. Results there were 126 cases in group A, including 55 males, 7 females, 13 cases of low grade urothelial carcinoma, 49 cases of high grade urothelial carcinoma, 64 cases of group B aged between 38 and 75 years, including 51 males and 13 females. Among them, there were 14 cases of low grade urothelial carcinoma and 50 cases of high grade urothelial carcinoma. The 1-year, 3-year and 5-year survival rates of patients in group A aged between 36 and 75 years were 90.32 and 67.74and 46.77 respectively. The survival rates of group B were 82.81% and 65.63%, respectively, and the survival rates of group B were significantly higher than those of group B (radical operation group was better than group B). The 1 year, 3 year and 5 year survival rates of partial cystectomy were 87.50% and 81.25% respectively after partial cystectomy. The survival rates of 1 year, 3 year and 5 year after radical cystectomy were 91.67%, 87.50% and 70.83%, respectively. There was no significant difference between the two groups. However, partial cystectomy had shorter operative time, less bleeding, and shorter hospital stay. And the quality of life of the patients with stage T3 was significantly better than that of the patients undergoing partial cystectomy combined with postoperative chemotherapy. The survival rates for 1 year, 3 years and 5 years after radical cystectomy were 93.33 and 53.33 respectively. The survival rates of 1, 3 and 5 years after radical cystectomy were respectively 1, 3 and 5 years, respectively. The 3- and 5-year survival rates were significantly different between the two groups. Conclusion 1. For patients with stage T2 bladder cancer, there was no difference in the survival rate of 1 and 5 years between partial cystectomy and radical resection, but the operation time was short, the amount of bleeding was less, the hospitalization time was short, and the quality of life of the patients was obviously better than that of radical surgery. Partial cystectomy is an optional procedure. For T 3 bladder cancer, the 5-year survival rate of radical surgery was higher than that of partial cystectomy.
【學(xué)位授予單位】：濟(jì)南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.14

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 魏曉松;莊乾元;胡志全;劉征;王志華;李凡;楊歡;WANG Shao-gang;;機(jī)器人輔助腹腔鏡與開放、腹腔鏡下膀胱根治性切除及Bricker回腸膀胱術(shù)比較分析[J];現(xiàn)代泌尿生殖腫瘤雜志;2016年02期

2 陳思;李劍峰;麥惠洪;;膀胱部分切除術(shù)在肌層浸潤性膀胱癌治療中的價(jià)值[J];中國醫(yī)藥科學(xué);2016年05期

3 李剛;李慶文;;膀胱部分切除術(shù)與根治性膀胱切除術(shù)治療T_2M_0N_0期膀胱癌的療效比較[J];蚌埠醫(yī)學(xué)院學(xué)報(bào);2016年03期

4 張勁松;李炯明;劉建和;陳戩;李曉濤;姜永明;郭海翔;王光;張海燕;海冰;;保留前列腺的根治性膀胱切除治療肌層浸潤性膀胱癌的適應(yīng)癥[J];昆明醫(yī)科大學(xué)學(xué)報(bào);2015年12期

5 王乾;曹敬毅;王淇超;吳剛;;肌層浸潤性膀胱癌保留膀胱術(shù)后髂內(nèi)動脈灌注化療的臨床療效[J];腫瘤防治研究;2015年08期

6 胡映秋;王曉榮;謝梅茂;趙雁;王忠軍;徐美玲;;吡柔比星與吉西他濱膀胱灌注化療治療膀胱癌的療效比較[J];現(xiàn)代腫瘤醫(yī)學(xué);2015年17期

7 穆中一;李剛;欒雪;劉世博;陳昂;付成;胡濱;;經(jīng)尿道膀胱腫瘤切除術(shù)穿孔相關(guān)危險(xiǎn)因素分析[J];現(xiàn)代泌尿外科雜志;2015年06期

8 曾蜀雄;張振聲;宋瑞祥;于曉雯;魯欣;李惠珍;陳新;馬重;趙俊杰;孫穎浩;許傳亮;;腹腔鏡下與開放式根治性膀胱切除術(shù)后早期并發(fā)癥的對比研究[J];中華泌尿外科雜志;2015年05期

9 王承承;孫曉玲;吳長利;;經(jīng)尿道電切術(shù)治療肌層浸潤性膀胱癌的療效分析[J];天津醫(yī)藥;2014年11期

10 張國輝;王金萍;鄭清友;李志輝;關(guān)亞偉;張勇;朱立夏;;肌層浸潤性膀胱癌保留膀胱手術(shù)后不同輔助治療方法的療效評價(jià)[J];現(xiàn)代泌尿外科雜志;2013年06期

相關(guān)碩士學(xué)位論文 前2條

1 李超;經(jīng)尿道綠激光膀胱腫瘤切除術(shù)與TURBT治療非肌層浸潤性膀胱腫瘤的臨床療效比較[D];山東大學(xué);2015年

2 曹匡緯;經(jīng)尿道電切術(shù)與2微米激光切除術(shù)治療淺表性膀胱癌的對比研究[D];第三軍醫(yī)大學(xué);2015年

，

本文編號：1896586