前列腺癌根治切除术中采用神经电调节改善早期排尿功能障碍的临床研究

目的 探讨前列腺癌根治切除术中采用神经电调节改善早期排尿功能障碍的临床效果.方法 2013年8月至2015年4月选择在本院泌尿外科进行诊治的前列腺癌患者120例,根据随机抽签原则分为观察组与对照组各60例,所有患者都给予腹腔镜下前列腺癌根治切除术,对照组在围手术期给予会阴部肌肉常规锻炼,观察组在对照组干预的基础上采用神经电调节治疗.结果 观察组的首次反射排尿时间和平衡膀胱建立时间分别为(7.81±2.14)d和(22.19 ±5.29)d,都明显少于对照组的(9.13±1.49)d和(25.30±6.14)d(P＜0.05).针对术后有效率进行研究发现,对照组和观察组的数据分别为88.3％和98.3％,观察组比对照组明显要高(P＜0.05).观察组术后6个月盆腔血肿、切口感染、吻合口漏、尿失禁、尿潴留等并发症发生情况明显少于对照组(P＜0.05).结论 前列腺癌根治切除术中采用神经电调节治疗可有效缓解患者排尿障碍的症状和体征,减少术后并发症的发生,有很好的临床应用价值.

Effect of bladder preserving surgery combined with internal iliac artery infusion chemotherapy for the treatment of muscle invasive bladder cancer

Objectives To investigate the clinical effect of adjuvant internal iliac artery infusion in patients with muscle invasive bladder cancer after resection of bladder tumor.Methods 84 patients who refused to accept or not accept bladder resection of muscle invasive bladder cancer in our hospital from January 2012 to January 2015 were selected,all patients underwent transurethral resection of bladder cancer (TURBT).After operation,all patients were divided into two groups,the control group (40 cases),the patients in the control group received systemic chemotherapy.In the experimental group,44 cases received internal iliac artery infusion chemotherapy.Bladder retention rate,adverse drug reaction,HIF-1 alpha,VEGF positive rate and three-year survival rate were compared between the two groups.Results HIF-1 alpha and VEGF positive rate in the experimental group (45.5％,36.4％) were lower than control group (65.0％,52.5％),there was statistically significant (P ＜ 0.05).There was statistically significant difference in the incidence of complications between the control group (45.0％) and experimental group(25.0％) (P ＜ 0.05).Follow-up of one year,bladder retention rate of the control group was 60.0％,and bladder retention rate of the experimental group was 81.8％,and the difference was statistically significant (P ＜0.05).Patients with Three-year survival rate of the control group and the xperimental group was 70.5％ and 52.5％,respectively (P ＜ 0.05).Conclusions The effect of internal iliac artery infusion chemotherapy in patients with muscle invasive bladder cancer is better,and it is suitable for clinical promotion.