摘要
目的探讨不同手术方式术后给予吉西他滨联合顺铂(GC)化疗方案在肌层浸润性膀胱癌治疗中的应用价值。方法选取2015年6月—2018年6月收治的肌层浸润性膀胱癌138例,根据手术方案分为经尿道膀胱肿瘤电切术(TURBT)组45例、经尿道膀胱肿瘤绿激光汽化术(PVBT)组44例、腹腔镜根治性膀胱切除术(LRC)组49例,3组术后均采用GC化疗方案。比较3组围手术期指标、生活质量、术后并发症发生率。随访2年,记录并比较3组术后2年生存率。结果PVBT组手术时间、胃肠蠕动恢复时间、下床时间、住院时间短于TURBT组及LRC组,术中出血量、输血量少于TURBT组及LRC组(P<0.05)。角色功能、情绪功能、社会功能、疼痛、总健康水平、未来看法、自身形象、性功能领域评分PVBT组高于TURBT组和LRC组,且TURBT组高于LRC组(P<0.05)。PVBT组术后并发症发生率低于TURBT组和LRC组(P<0.05)。3组术后2年生存率比较差异无统计学意义(P>0.05)。结论PVBT对肌层浸润性膀胱癌生活质量改善效果好,且安全性高。
Objective To evaluate application values of different surgical methods combined with postoperative Gemcitabine and Cisplatin(GC)chemotherapy in treatment of patients with myometrial invasive bladder cancer.Methods A total of 138 patients with myometrial invasive bladder cancer admitted between June 2015 and June 2018 were selected and divided into transurethral resection of bladder tumor with green laser group(TURBT group,n=45),transurethral photoselective vaporization of bladder tumor group(PVBT group,n=44)and laparoscopic radical cystectomy group(LRC group,n=49)according to different therapeutic methods.The three groups were all given postoperative GC chemotherapy.Perioperative indicators,quality of life and incidence rate of postoperative complications were compared among three groups.All the patients were followed up for 2 years,and the postoperative 2-year survival rates were recorded and compared among three groups.Results In PVBT group,operative duration,recovery time of gastrointestinal motility,the time of out off bed and length of stay were significantly shorter(P<0.05),and the intraoperative volume of blood loss and blood transfusion volume were significantly less than those in TURBT and LRC groups(P<0.05).Scores of role function,emotional function,social function,pain,general health level,future outlook,self-image and sexual function fields were the highest in PVBT group,followed by TURBT group and LRC group(P<0.05).Incidence rate of postoperative complications in PVBT group was lower than those in TURBT and LRC groups(P<0.05).There were no significant differences in the postoperative 2-year survival rates among 3 groups(P>0.05).Conclusion PVBT has good effect in improving quality of life of patients with myometrial invasive bladder cancer with good safety.
作者
王传亮
李永启
易勇
闫家文
陈思奎
卢家镇
WANG Chuan-liang;LI Yong-qi;YI Yong;YAN Jia-wen;CHEN Si-kui;LU Jia-zhen(Department of Urinary Surgery,Central Hospital of Shangluo City,Shangluo,Shaanxi 726000,China)
出处
《解放军医药杂志》
CAS
2021年第12期20-23,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省卫生厅课题(2018Z067)。
关键词
膀胱肿瘤
经尿道膀胱肿瘤绿激光汽化术
抗肿瘤联合化疗方案
生活质量
手术后并发症
Urinary bladder neoplasms
Transurethral photoselective vaporization of bladder tumor with green laser
Antineoplastic combined chemotherapy protocols
Quality of life
Postoperative complications
