经尿道膀胱肿瘤电切术对膀胱癌患者生存情况及不良反应的影响

目的：探讨经尿道膀胱肿瘤电切术（TURBt）对膀胱癌的治疗效果，分析其安全性和有效性。方法回顾性分析85例膀胱癌患者的临床资料，根据手术方式不同将患者分为膀胱部分切除组（36例）和TURBt组（49例）。观察两组患者的手术一般情况，比较两组患者术后生存率、肿瘤标志物水平和不良反应发生情况。结果TURBt组患者手术时间和术后留置导尿管时间均较膀胱部分切除组短（t=54.396、10.215，P﹤0.001），术中出血量较膀胱部分切除组少（t=42.843，P﹤0.001）；两组患者的中位随访时间为51个月，95%CI为18～80个月；TURBt组患者的生存情况明显优于膀胱部分切除组；手术前，两组患者的肿瘤标志物水平比较，差异无统计学意义（P﹥0.05），出院前，TURBt组患者的CEA、CA19-9和CA125水平均低于膀胱部分切除组（P﹤0.001）；TURBt组不良反应总例数少于膀胱部分切除组（P=0.001）。结论 TURBt对膀胱癌患者有较好的治疗效果，且对排尿功能影响较小，具有较好的临床应用价值。

Effect of transurethral resection of bladder tumor on the total survival and adverse reactions of patients with bladder cancer

Objective To investigate the therapeutic efficacy of transurethral resection of bladder tumor (TURBt) in the treatment of bladder cancer, and to analyze the safety and efficacy of the therapy. Method The clinical data of 85 pa-tients with bladder cancer were retrospectively analyzed. Patients underwent partial cystectomy (n=36) or TURBt (n=49) were observed and compared for survival rate, tumor marker level and incidence of adverse reactions. Result Compared with patients underwent partial cystectomy, the patients in TURBt group had shorter operative time, shorter time needed for indwelling urinary catheter (t=54.396, 10.215, P<0.001), and less intraoperative blood loss (t=42.843, P<0.001);The median follow-up time was 51 months in both groups (95%CI, 18-80 months);The survival of patients given TURBt was significantly better than that of patients with partial cystectomy;While the level of tumor markers in the two groups were comparable before surgery (P>0.05), and before discharge, the CEA, CA19-9 and CA125 levels of in TURBt group were lower than those in partial cystectomy group (P<0.001), and less total cases of adverse reactions were observed in TURBt group (P=0.001). Conclusion Transurethral resection of bladder tumor is of fair therapeutic effect in in patients with bladder cancer, with limited restriction on micturition function, and is clinically applicable.