钬激光技术治疗非肌层浸润性膀胱癌的临床疗效分析

目的 评价经尿道钬激光膀胱肿瘤切除术治疗非肌层浸润性膀胱肿瘤（non-muscle invasive bladder cancer,NMIBC）的临床疗效。方法 回顾性分析167例分别行经尿道钬激光膀胱肿瘤切除术（78例）与 经尿道膀胱肿瘤切除术（transurethral resection of bladder tumor,TURBT）（89例）的 NMIBC 患者的临床资料，比较手术时间、术中闭孔神经反射、膀胱穿孔发生率及术后复发率等指标。结果 钬激光组手术时间与电切镜组无明显差异（P＞0.05）；术中闭孔神经反射率、膀胱穿孔发生率、术后出血发生率等方面钬激光组明显少于电切镜组（P<0.05）；两组患者术后复发率差异无统计学意义（P>0.05）。结论 钬激光在治疗 NMIBTC方面同电切一样疗效确切，但钬激光手术方法易于掌握、安全性高且并发症少。值得临床可合理选择运用。

Clinical analysis of transurethral holmium laser therapy for non-muscle invasive bladder cancer

Objective  To evaluate the advantages and disadvantages of holmium laser resection and transurethral resection for the treatment of non-muscle invasive bladder cancer（NMIBC）.Methods  The clinical records of totally 167 patients with NMIBC were divided into transurethral holmium laser resection of bladder cancer(HOLRBT) group（n=78） and TURBT group（n=89）. The operation time，obturator nerve reflex,the rate of intraoperative bladder perforation, the incidence of postoperative bleeding and the rate of tumor recurrence were compared between the two groups.Results  The mean operation time was similar in the two groups (P>0.05). Less obturator nerve reflex, the rate of intraoperative bladder perforation and the incidence of postoperative bleeding were observed in HOLRBT group(P<0.05). The rate of tumor recurrence was similar in the two groups(P>0.05). Conclusions  The HOLRBT therapy has definite effects on the treatment of NMIBT as TURBT.Compared with the TURBT，HOLRBT has more advantages with wieldy operation method，high security and low complication. In short，we should choose the suitable operation means according to the different conditions.