摘要
目的探讨肌层浸润性膀胱癌(MIBC)患者应用经尿道膀胱肿瘤电切术(TURBT)联合吉西他滨+顺铂(GC)方案化疗对保留膀胱术后效果及远期生存率的影响。方法回顾性选取2015年1月至2018年3月在辽宁省朝阳市第二医院接受治疗的68例MIBC患者作为研究对象,根据治疗方式不同将患者分为保膀胱组(n=34)与根治组(n=34)。根治组患者应用根治性膀胱切除术(RC)联合GC方案化疗,保膀胱组应用TURBT手术联合GC方案化疗。比较两组患者的临床指标、术后并发症与化疗毒副作用发生率、远期复发及生存情况。结果保膀胱组患者的手术时间、住院时间、胃肠功能恢复时间短于根治组,术中出血量少于根治组,差异有统计学意义(P<0.05);保膀胱组患者术后出血、泌尿感染、肠梗阻、肺部感染等并发症总发生率低于根治组,差异有统计学意义(P<0.05);两组患者的化疗毒副作用发生率及术后1、2、4年复发率、生存率比较,差异无统计学意义(P>0.05)。结论TURBT手术联合GC方案化疗在MIBC患者中的应用能够缩短手术时间,在保障远期生存率基础上降低术后并发症发生风险,促进患者后续康复。
Objective To investigate the effect of transurethral resection of bladder tumor(TURBT)combined with Gemcitabine+Cisplatin(GC)chemotherapy on bladder preservation and long-term survival in patients with muscular invasive bladder cancer(MIBC).Methods A total of 68 patients with MIBC who were treated in the Second Hospital of Chaoyang City,Liaoning Province from January 2015 to March 2018 were retrospectively selected as the research subjects.According to different treatment methods,the patients were divided into bladder preservation group(n=34)and radical cure group(n=34).Radical cystectomy(RC)combined with GC was applied in the radical cure group,while TURBT surgery combined with GC was applied in the bladder preservation group.The clinical indexes,postoperative complications,incidence of chemotherapy toxicity and side effects,long-term recurrence and survival were compared between the two groups.Results The operation time,hospital stay and gastrointestinal function recovery time of the bladder preservation group were shorter than those of the radical group,and the intraoperative blood loss was less than that of the radical cure group,the differences were statistically significant(P<0.05).The total incidence of postoperative complications such as bleeding,urinary infection,intestinal obstruction and pulmonary infection in the bladder preservation group was lower than that in the radical cure group,and the difference was statistically significant(P<0.05).There were no significant differences in the incidence of chemotherapy toxicity and side effects,recurrence rate and survival rate 1,2 and 4 years after surgery between 2 groups(P>0.05).Conclusion The application of TURBT surgery combined with GC chemotherapy in MIBC patients can shorten the operation time,reduce the risk of postoperative complications on the basis of ensuring long-term survival rate,and promote the subsequent recovery of patients.
作者
张凯
贺仁杰
赵明
ZHANG Kai;HE Renjie;ZHAO Ming(Department of Urology,the Second Hospital of Chaoyang City,Liaoning Province,Chaoyang122000,China)
出处
《中国当代医药》
CAS
2023年第10期22-25,共4页
China Modern Medicine
