HOLRBT与TURBT对表浅性膀胱癌的临床疗效分析比较

目的：探讨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）对表浅性膀胱癌的临床疗效及尿管留置时间的差别。方法回顾性分析120例膀胱癌患者的临床资料，根据其手术方式分为HOLRBT组和TURBT组。观察两组患者手术一般情况，比较两组患者手术前后排尿功能、生活质量和并发症发生情况的差别。结果 HOLRBT组患者术中出血量较TURBT组少，术后留置尿管时间较TURBT组短（t=27.352、8.854，P﹤0.001）；两组患者术后1个月的排尿功能差异无统计学意义，术后6个月，HOLRBT组的IPSS得分低于TURBT组，Qmax得分高于TURBT组（t=43.619、-8.412，P﹤0.001）；两组膀胱穿孔、继发性出血和发热并发症发生情况差异无统计学意义（χ2=1.163，P=0.281），HOLRBT组复发情况明显低于TURBT组（χ2=4.881，P=0.027）；两组患者手术前生活质量得分差异无统计学意义，术后1个月，HOLRBT组躯体功能、躯体角色和总体健康等维度得分高于TURBT组。结论经尿道钬激光膀胱肿瘤切除术对膀胱癌有较好的治疗效果，安全性高，可减少复发，具有临床推广应用的价值。

Comparative analysis of the clinical efficacy of HOLRBT and TURBT in superficial bladder cancer

Objective To investigate the clinical effect of transurethral holmium laser resection of bladder tumor (HOLRBT) and transurethral resection of bladder tumor (TURBT) in the treatment of bladder tumor and evaluate the time needed for indwelling catheter. Method The clinical data of patients with bladder cancer who underwent surgical treatment were retrospectively analyzed, patients receiving HOLRBT (HOLRBT group) or TURBT (TURBT group) were observed for urinary function and quality of life before and after surgery as well as the incidence of complications after surgery. Result HOLRBT group had less intra-operative blood loss, and shorter time of indwelling catheter than TURBT group (t=27.352, 8.854, P<0.001);The two groups of patients had similar urinary function in 1 month after sur-gery, while in 6 months after the surgery, HOLRBT group had lower IPSS score and higher Qmax score than TURBT group (t=43.619,-8.412, P<0.001);the incidence of bladder perforation, secondary bleeding and fever were comparable in the two groups (χ2=1.163, P=0.281), though the recurrence rate in HOLRBT group was significantly lower than that of TURBT group (χ2=4.881, P=0.027);besides, the two groups had similar quality of life scores before surgery, and the scores regarding physical function, physical role and overall health of HOLRBT group were higher than those of TURBT group in 1 month after surgery. Conclusion Transurethral holmium laser resection of bladder cancer is fairly ef-fective, with acceptable safety, which can reduce recurrence rate, and is clinically applicable.