经尿道选择性绿激光汽化术与电切术治疗膀胱表浅肿瘤的比较研究

目的比较经尿道选择性绿激光汽化术和电切术治疗膀胱表浅肿瘤的疗效,探讨经尿道选择性绿激光汽化术治疗膀胱表浅肿瘤的安全性和疗效。方法采用单盲随机方式对48例膀胱表浅肿瘤患者分别采用经尿道选择性绿激光汽化术（A组）和电切术（B组）治疗,各24例,观察两组术中、术后并发症及复发情况。结果 B组术中有8例发生闭孔神经反射,7例发生膀胱穿孔（其中6例因闭孔神经反射而发生穿孔）,术后继发出血2例,尿道狭窄1例,随访3～36个月复发10例;A组仅有1例发生膀胱穿孔,复发1例。A组并发症发生率为4.16%,复发率为4.16%;B组并发症发生率为50%,复发率为41.7%（P〈0.01）。结论膀胱表浅肿瘤宜选用经尿道选择性绿激光汽化术治疗。

Comparison between transurethral green laser vaporization resection and electrocision for the superficial bladder tumor

Objective To compare the curative effect of transurethral green laser vaporization resection and electrocision for the superficial bladder tumor.Methods Using A single blind randomized method,transurethral green laser vaporization resection(Group A,24 cases) and electrocision(Group B,24 cases),was employed to treat 48 cases with superficial bladder tumors.Then the intraoperative and postoperative complications and relapses was observed.Results In Group A,7 patients had bladder perforation and 1 patient suffered a relapse.In Group B,8 patients had obturator nerve reflex,and 7 patients had bladder perforation(the perforation of the 6 patients in them were caused by obturator nerve reflex),the secondary bleeding after surgery appeared in 2 patients,1 patient had urethral stricture and 10 patients suffered a relapse in follow-up survey from 3 to 36 months.The complication rate of Group A was 4.16%,while the recurrence rate was 4.16%.The complication rate of Group B was 50%,while the recurrence rate was 41.7%(P<0.01).Conclusion Transurethral green laser vaporization resection is better than electrocision to treat the superficial bladder tumor.