根治性膀胱切除术前后实施扩大盆腔淋巴结清扫术对患者临床疗效的影响

目的 探究根治性膀胱切除术前后实施扩大盆腔淋巴结清扫术对患者临床疗效的影响.方法 将拟行根治性膀胱切除术和扩大盆腔淋巴结清扫术的膀胱癌患者按随机数字表法分成两组,术前清扫组（52例）采用在根治性膀胱切除术前实施扩大盆腔淋巴结清扫术;术后清扫组（54例）采用在根治性膀胱切除术后实施扩大盆腔淋巴结清扫术.结果 术前清扫组根治性膀胱切除术所用时间明显少于术后清扫组（78.6±24.5） min比（115.1 ±29.7） min],髂内和髂前清除淋巴结个数明显少于术后清扫组（5.4±2.3）枚比（7.3±3.1）枚和（1.4±1.0）枚比（2.4±1.5）枚],盆腔总淋巴结清除数明显少于术后清扫组（25.6±8.3）枚比（29.1±8.5）枚],差异有统计学意义（P＜0.05）.两组患者出现静脉损伤、淋巴瘘延迟拔引流管等并发症情况比较差异无统计学意义（P＞0.05）.结论 根治性膀胱切除术时,先实施扩大盆腔淋巴结清扫术的方式对患者疗效较好.

Influence of clinical effect before and after the implementation of extended pelvic lymph node excision on patients with radical cystectomy

Objective To compare the clinical effect before and after the implementation of extended pelvic lymph node excision on patients with radical cystectomy.Methods The patients underwent radical cystectomy and extended pelvic lymph node excision for bladder cancer patients were divided into two groups by random digits table method,preoperative excision group （52 cases） used in radical cystectomy after the implementation of extended pelvic lymph node excision,postoperative excision group （54 cases） used in radical cystectomy before the implementation of extended pelvic lymph node excision.Results The operation time of radical cystectomy in preoperative excision group was significantly shorter than that in postoperative excision group （78.6 ± 24.5） min vs.（115.1 ± 29.7） min],the number of iliac and anterior iliac lymph node excision was significantly lower than that in postoperative excision group （5.4 ± 2.3） pieces vs.（7.3 ± 3.1） pieces and （1.4 ± 1.0） pieces vs.（2.4 ± 1.5） pieces],the number of total pelvic lymph node excision was significantly lower than that in postoperative excision group （25.6 ± 8.3） pieces vs.（29.1 ± 8.5） pieces],there were statistical differences （P 〈 0.05）.There were no statistical differences in vein injury,lymphatic fistula delayed removal of drainage tube and other complications occurred in 2 groups （P 〉 0.05）.Conclusion Before radical cystectomy,the first implementation of the expansion pelvic lymph node excision is a safe and effective way in patients.