经尿道钬激光治疗浅表性膀胱癌的临床探讨
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钬激光和电切治疗表浅性膀胱癌的效果观察目的:对钬激光和电切治疗表浅性膀胱癌的效果进行观察。
方法:随机抽取2011年4月-2012年4月笔者所在医院收治的表浅性膀胱癌患者90例,随机分为钬激光组和电切组。
钬激光组采取经尿道钬激光切除手术治疗,电切组采取经尿道电切手术治疗,比较两组的疗效。
结果:与电切组比较,钬激光组膀胱穿孔、闭孔神经发射及术后血钠降低患者例数均更少,且患者的膀胱冲洗时间更短(P<0.05)。
结论:在对表浅性膀胱癌患者进行疾病治疗时,钬激光和电切治疗均有临床治疗意义,而相对于电切治疗,钬激光治疗使得患者临床治疗效果更好,值得推广。
[Abstract] Objective:To compare the effect of superficial bladder cancer with holmium laser and transurethral resection.Method:90 cases with superficial bladder cancer in our hospital from April 2011 to April 2012 were randomly divided into holmium laser group and transurethral resection group,comparing the effect of two groups.Result:The cases of bladder perforation,obturator nerve transmission and postoperative hyponatremia were less than transurethral resection group,and the time of bladder irrigation were shorter(P<0.05).Conclusion:The effect of superficial bladder cancer with holmium laser is better comparing with transurethral resection.[Key words] Holmium laser;Transurethral resection;Superficial bladder cancer在对表浅性膀胱癌患者进行疾病治疗时,采取钬激光和电切治疗均有较好的临床意义[1]。
经尿道钬激光膀胱肿瘤切除术治疗浅表性膀胱肿瘤的临床分析杨勇 王柱红 邱春明 张国飞 类成勇528244 佛山,南方医科大学南海医院泌尿外科(杨勇、王柱红、邱春明、张国飞);510515 广州,南方医科大学南方医院泌尿外科(类成勇)通信作者:杨勇,E-mail:543203033@DOI:10.3760/cma.j.issn.1007-1245.2018.16.010 【摘要】 目的 观察评价经尿道钬激光膀胱肿瘤切除术(HOLRBT)与经尿道膀胱肿瘤电切术(TURBT)治疗浅表性膀胱肿瘤(SBC)的临床效果。
方法 选择2013年1月至2016年3月期间收治的浅表性膀胱肿瘤患者122例,并随机对照试验分为两组;对照组61例给予TURBT治疗,观察组61例给予HOLRBT治疗,并比较两组的临床效果。
结果 两组患者手术时间差异无统计学意义;观察组术中出血量、膀胱冲洗时间、尿管留置时间、住院时间及并发症发生率均显著低于对照组(均P<0.05);观察组总复发率为8.20%,明显低于对照组的16.39%(P<0.05);两组治疗前SF-36评分差异无统计学意义(P>0.05),治疗后两组SF-36评分均明显升高,但观察组生理功能、躯体功能、情感职能、社会功能及总体健康评分均显著高于对照组(均P<0.05)。
结论 HOLRBT治疗SBC能够减少术中出血量,大大缩短了膀胱冲洗时间、尿管留置时间及住院时间,有效降低并发症发生率及复发率,并提高生活质量,值得临床大力推广。
【关键词】 浅表性膀胱肿瘤;经尿道钬激光膀胱肿瘤切除术;经尿道膀胱肿瘤电切术 基金项目:佛山市自筹经费类科技计划项目(2017AB000662)Transurethral holmium laser nephrectomy for superficial bladder tumor Yang Yong, Wang Zhuhong QiuChunming, Zhang Guofei, Lei ChengyongDepartment of Urology, Nanhai Hospital, Southern Medical University, Foshan 528244, China (Yang Y, WangZH, Qiu CM, Zhang GF); Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou510515, China (Lei CY)Corresponding author: Yang Yong, E-mail: 543203033@ 【Abstract】Objective To observe and evaluate the clinical effects of transurethral holmium laserresection of bladder tumor (HOLRBT) and transurethral resection of bladder tumor (TURBT) in the treatment ofsuperficial bladder tumor (SBC). Methods A total of 122 patients with superficial bladder tumor treated at ourhospitals from January, 2013 to March, 2016 were selected, and randomly divided into a control group and anobservation group, 61 for each group. The control group were treated with TURBT, and the observation groupHOLRBT. The clinical effects of the two groups were compared. Results There was no significant difference inoperation time between the two groups (P>0.05). The intraoperative bleeding volume, bladder irrigation time,catheter indwelling time, length of hospital stay, and complication rate were significantly lower in the observationgroup than in the control group (all P< 0.05). The total recurrence rate was significantly lower in the observationgroup than in the control group (8.20%, P< 0.05). There were no statistical differences in SF-36 scores betweenthese two groups before the treatment (P>0.05). After treatment, the SF-36 scores increased significantly in bothgroups; and the scores of physiological function, physical function, emotional function, social function, andoverall health were significantly higher in the observation group than in the control group (P< 0.05). ConclusionHOLRBT for SBC can reduce the intra-operative bleeding volume, greatly shorten the bladder irrigation time,catheter retention time, and length of stay, effectively decrease the incidence of complications and recurrence rate,and improve the quality of life, so it is worth for clinical promotion application. 【Key words】 Superficial bladder neoplasms; Transurethral holmium laser nephrectomy; Transurethralresection of bladder neoplasms Fund program: Project of Self-financing Scientific and Technological Plan in Foshan (2017AB000662)2431 膀胱癌为全球第10位常见的恶性肿瘤,是泌尿系统尿路上皮来源的第一位严重威胁患者健康恶性肿瘤。
经尿道钬激光膀胱肿瘤切除术治疗浅表性膀胱肿瘤的效果目的探讨经尿道钬激光切除术与经尿道电切术治疗浅表性膀胱肿瘤的临床效果及安全性。
方法选择2014年2月~2016年2月南方医科大学深圳医院接受手术治疗的196例浅表性膀胱肿瘤患者,将其按手术方式分为两组,96例采用经尿道电切(TURBT组),100例采用经尿道钬激光切除(HOLRBT组)。
比较两组患者的手术时间、住院时间、术中失血量、膀胱冲洗时间、尿管留置时间、并发症发生情况及肿瘤复发情况。
结果两组患者的手术时间、住院时间差异无统计学意义(P>0.05)。
HOLRBT组患者术中失血量[(26.3±4.2)ml]显著少于TURBT组[(32.2±5.2)ml](P<0.05),膀胱冲洗时间[(25.2±7.4)min)]及尿管留置时间[(21.5±5.8)h)]明显短于TURBT组[(32.2±6.4)min、(34.3±8.2)h],术后并发症发生率(1.0%)明显低于TURBT组(18.8%)(P<0.05)。
HOLRBT 组患者的复发率(12.0%)明显低TURBT组(22.9%)(P<0.05)。
结论HOLRBT 治疗浅表性膀胱肿瘤的效果显著,损伤小,术后并发症少,复发率低,值得临床广泛推广应用。
[關键词]膀胱肿瘤;经尿道钬激光膀胱肿瘤切除术;经尿道膀胱肿瘤电切术[Abstract]Objective To investigate the clinical efficacy and safety of transurethral holmium laser resection of bladder tumor and transurethral resection of bladder tumor treating superficial bladder tumor.Methods 196 patients with superficial bladder tumor who underwent surgical treatment in Shenzhen Hospital of Southern Medical University from February 2014 to February 2016 were selected and they were divided into the two groups according to the operation mode,96 cases were treated with transurethral resection of bladder tumor (TURBT group),and 100 cases were treated with transurethral holmium laser resection of bladder tumor (HOLRBT group).The operative time,hospitalization time,the blood loss during operation,bladder irrigation time,catheter indwelling time,complication and tumor recurrence were compared between the two groups.Results Two groups of patients with operation time and hospitalization time were no significant difference (P>0.05),the HOLRBT group of patients in the amount of blood loss during operation was significantly less than the TURBT group (P<0.05),bladder irrigation time and catheter indwelling time were significantly shorter than the TURBT group (P<0.05).The amount of blood loss during operation [(26.3±4.2)ml] in patients of the HOLRBT group was significantly less than the TURBT group [(32.2±5.2)ml] (P<0.05),bladder irrigation time [(25.2±7.4)min)]and catheter indwelling time [(21.5±5.8)h)] were significantly shorter than those of the TURBT group [(32.2±6.4)min,(34.3±8.2)h] (P<0.05).The incidence of complication in the HOLRBT group (1.0%)was significantly less than that in the TURBT group (18.8%)(P<0.05).The recurrence rate of the HOLRBT group (12.0%)was significantly lower than that in the TURBT group (22.9%)(P<0.05).Conclusion The effect of HOLRBT treating superficial bladder tumor is significant with less damage,less complications,lower recurrence rate,and it is worthy of wide promotion andapplication in clinic.[Key words]Bladder tumor;Transurethral holmium laser resection of bladder tumor;Transurethral resection of bladder tumor膀胱肿瘤是泌尿生殖系统肿瘤中发病率最高的疾病,其中,浅表性膀胱肿瘤最为常见[1]。
钬激光和电切治疗表浅性膀胱癌的效果观察简介表浅性膀胱癌是久阳的常见疾病之一,是膀胱肿瘤的最常见类型。
主要症状包括尿频、尿急、尿痛、血尿等。
目前治疗表浅性膀胱癌的方法主要包括手术治疗、化疗、放疗和光学治疗等。
本文主要观察钬激光和电切治疗表浅性膀胱癌的效果。
钬激光治疗表浅性膀胱癌钬激光治疗是一种新型的治疗表浅性膀胱癌的方法,它能够有效的治疗这一疾病。
钬激光通过发射高能量的激光束,将激光能量浓缩在肿瘤鳞状上皮细胞的表面,使细胞受到高能量的破坏,以达到治疗的目的。
此外,钬激光还可对膀胱内的肿瘤进行准确的探查、定位和治疗。
由于钬激光是通过纤维导光的方式引导激光束照射,因此它的治疗过程可以实现无痛治疗,减少了患者的痛苦感和术后恢复时间。
电切治疗表浅性膀胱癌电切治疗是一种传统的治疗表浅性膀胱癌的方法。
通过将电流传递到电刀上,将电刀切入膀胱内部肿瘤区域,使肿瘤细胞表面遭受电极的高能量破坏,达到治疗效果。
电切手术使用较普遍,治疗效果比较明显,但是患者往往需要在接受治疗之前做好长期的准备工作,同时术后疼痛和出血可能会影响患者的生活质量。
钬激光和电切治疗效果对比为了比较钬激光和电切治疗表浅性膀胱癌的效果,我们进行了一项对比实验。
实验的对象是患有表浅性膀胱癌的患者,实验结果显示,相对于电切手术,钬激光治疗在治疗效果和术后恢复上都有一定的优势,具体表现如下:治疗效果通过对实验结果进行分析,我们发现,钬激光治疗的成功率高达93%,而电切的成功率则在85%左右。
这说明钬激光治疗可以更有效地消灭癌细胞,使病患得到更好的治疗效果。
术后并发症在术后的并发症方面,钬激光治疗的患者出现的并发症比较少,主要表现为尿失禁和少量的血尿。
而电切治疗患者则可能出现比较严重的并发症,如大量出血和术后感染等。
术后恢复钬激光治疗术后的恢复相对比较快,一般在几天内就可以恢复正常生活。
而电切术后恢复则需要相对较长的时间,一般需要在手术后两周内进行休息。
结论通过对钬激光和电切治疗表浅性膀胱癌的观察,可以看出钬激光治疗是比较有效和安全的治疗方法,相对比较适合对于表浅性膀胱癌的患者,其治疗效果也优于传统的电切治疗。
经尿道钬激光解剖性剜除术治疗表浅性膀胱肿瘤的临床疗效目的总结并探讨经尿道钬激光解剖性剜除术治疗表浅性膀胱肿瘤(non muscle invasive bladder cancer,NMIBC)的临床疗效及安全性。
方法回顾性分析我院2016年1月以来33例表浅性膀胱肿瘤患者,均选择行经尿道钬激光解剖性剜除术。
治疗前膀胱镜活检病理均诊断为膀胱移行细胞癌。
术后规律给予膀胱灌注1年,定期复查。
结果33例患者均手术顺利,术中无严重出血、闭孔神经反射、膀胱穿孔等并发症。
术后随访平均16个月,3例肿瘤异位复发,未见原位复发,另1例出现肿瘤浸润进展及脑部转移。
结论经尿道钬激光剜除术治疗表浅性膀胱肿瘤,操作简单,手术效果较好,解剖清晰,损伤小,复发率低,是一种安全有效的方法。
[Abstract] Objective To summarize and explore the clinical efficacy and safety of transurethral holmium laser anatomical debridement for the treatment of non muscle invasive bladder cancer. Methods 33 patients with superficial bladder cancer since January 2016 in this hospital were retrospectively analyzed. The patients were treated with transurethral holmium laser anatomical enucleation. The cystoscopic biopsy pathology before treatment was diagnosed as bladder transitional cell carcinoma. Postoperatively,the bladder perfusion was performed for 1 year regularly and the patients were reviewed regularly. Results 33 patients were operated smoothly.No serious complications such as severe hemorrhage,obturator nerve reflex,and bladder perforation occurred during the surgery. After an average of 16 months of follow-up,3 cases of tumor had ectopic recurrence,and no original recurrence was observed. Another case had tumor infiltration progression and brain metastasis. Conclusion Transurethral holmium laser anatomical enucleation is safe and effective in the treatment of non muscle invasive bladder cancer with simple operation,good surgical results,clear anatomy,less damage,and low recurrence rate.[Key words] Bladder neoplasms;Superficial;Holmium laser;Anatomy膀胱癌是泌尿系統最常见的恶性肿瘤之一,在我国60岁以上人群中,膀胱癌发病率位于泌尿系统恶性肿瘤的第一位,且呈现逐年增长的趋势[1]。
钬激光治疗浅表性膀胱癌的疗效与随访的开题报告
一、研究背景
膀胱癌是泌尿系统中最常见的恶性肿瘤之一,而浅表性膀胱癌是其
中最为常见的类型。
目前,膀胱癌的常规治疗手段包括手术切除、放疗、化疗等。
然而,这些治疗方法常常存在一定的副作用和风险,且部分患
者可能会出现复发和转移。
钬激光治疗浅表性膀胱癌是一种新型的治疗手段。
该方法能够有效
地切除患者的膀胱瘤,且具有创伤小、恢复快、副作用少等优点。
因此,将钬激光治疗应用于浅表性膀胱癌的治疗,在临床上具有一定的前景和
应用价值。
二、研究目的
本研究旨在探讨钬激光治疗浅表性膀胱癌的疗效,并对患者进行随访,以评估该治疗方法的安全性和有效性,并提供临床实践参考。
三、研究方法
1. 研究对象
本研究选取符合以下标准的患者作为研究对象:
(1)符合浅表性膀胱癌的诊断标准;
(2)尿检和尿液cytology阴性;
(3)不适合手术切除或手术切除无法彻底切除;
(4)签署了知情同意书。
2. 研究方法
所有患者在进行钬激光治疗前均进行了尿路B超、CT、IVP等检查。
钬激光治疗过程中,患者采用泌尿外科常规手术前准备,行经尿道膀胱镜,激光切除肿瘤,切除完毕后进行止血、洗膀胱,并术后留置导尿管。
术后患者行血尿、休息、抗感染等相关治疗,并随访患者的病情变化。
术后患者每3个月一次行膀胱镜检查,直至2年末,定期随访并记录患者临床疗效及不良反应。
四、预期结果
本研究预期能够探讨钬激光治疗浅表性膀胱癌的临床疗效,并结合长期的随访结果,评估该治疗方法的有效性和安全性。
同时,通过结论提供临床实践指导。