窄谱光成像（NBI）辅助钬激光治疗非肌层浸润膀胱尿路上皮癌的临床应用价值

目的:探究窄谱光成像（narrow band imaging，NBI）辅助钬激光治疗非肌层浸润膀胱尿路上皮癌（non-muscle invasive bladder cancer，NMIBC）的临床应用价值。方法:选取2014年2月至2016年2月本院收治的NMIBC患者82例为研究对象。按照简单随机分组方法将患者分为两组，研究组（n=41）患者行NBI辅助钬激光治疗，对照组（n=41）患者行普通白光成像（white light imaging，WLI）辅助钬激光治疗。观察两组手术时间、并发症（闭孔神经反射、膀胱穿孔）发生率、首次随访（术后3个月）肿瘤残留率；术后3个月、6个月、12个月肿瘤复发率；肿瘤原位及异位复发情况。结果:研究组手术时间短于对照组，并发症中闭孔神经反射发生率低于对照组，首次随访肿瘤残留率亦低于对照组，差异均有统计学意义（P<0.05）。研究组患者术后3个月、6个月、12个月复发率均低于对照组；术后总复发率研究组为9.76%，明显低于对照组的31.71%，差异有统计学意义（P<0.05）。研究组患者肿瘤原位复发率（2.44%）明显低于对照组（19.51%）(P<0.05)；而肿瘤异位复发率于两组间比较无统计学差异（P>0.05）。结论:NBI辅助钬激光治疗NMIBC操作简便，可缩短手术时间，且安全性高，疗效确切，能够显著降低NMIBC患者肿瘤残留率及复发率、原位复发率，颇具临床应用价值，可作为NMIBC的理想治疗方式。

Clinical value of narrow band imaging (NBI) assisted holmium laser in the treatment of non-muscle invasive bladder cancer

Objective:To explore the clinical value of narrow band imaging (NBI) assisted holmium laser in the treatment of non-muscle invasive bladder cancer (NMIBC).Methods:Eighty-two patients with NMIBC from February 2014 to February 2016 in our hospital were selected as the research objects.The patients were divided into two groups according to the simple randomization method.The study group (n=41) received NBI assisted holmium laser treatment.Patients in the control group (n=41) were treated with white light imaging (WLI) assisted holmium laser therapy.The operation time，complications (obturator nerve reflex，perforation of bladder)，the rate of residual tumor in the first follow-up (3 months after operation)，the recurrence rate of tumor at 3 months，6 months and 12 months after operation，and the recurrence of tumor in situ and ectopic recurrence in two groups were observed.Results:Operation time of the study group was shorter than the control group，and the incidence rate of complications of obturator nerve reflex was lower than the control group，and the first follow-up rate of residual tumor was lower than that of the control group.The differences were statistically significant (P<0.05).The recurrence rates of 3 months,6 months，12 months after operation were lower than the control group.The total recurrence rate in study group after operation was 9.76%，significantly lower than the control group (31.71%)，and the difference was statistically significant (P<0.05).The tumor recurrence rate in situ in the study group (2.44%) was significantly lower than that in the control group (19.51%) (P<0.05)，while the ectopic recurrence rate was not significantly different between the two groups (P>0.05).Conclusion:NBI assisted holmium laser in the treatment of NMIBC is simple，can shorten the operation time，has high safety and accurate curative effect，can significantly reduce the residual rate and recurrence rate of NMIBC patients and the rate of recurrence in situ，has clinical application value，can be used as an ideal treatment for NMIBC.