TURBT术后联合化疗与根治性膀胱切除术治疗肌层浸润性膀胱癌的疗效对比研究

目的:分析对比经尿道膀胱肿瘤切除术（transurethral bladder tumor，TURBT）术后联合静脉化疗与根治性膀胱切除术治疗肌层浸润性膀胱癌的临床效果以及生活质量。方法:回顾性分析2014年07月至2017年03月我院肌层浸润性膀胱癌患者73例，其中TURBT术后行静脉化疗39例为观察组，行根治性膀胱切除术34例为对照组。观察对比两组围术期指标、术后并发症发生情况、术后随访2年内复发和生存情况以及患者术后生活质量评价。结果:观察组手术时间、术中出血量、住院时间均明显低于对照组，差异有统计学意义（P＜0.05）。观察组术后并发症总发生率为10.3%（4/39）；对照组术后并发症总发生率为32.4%（11/34），两组比较差异有统计学意义（P＜0.05）。观察组和对照组术后3个月、6个月复发率比较无显著差异（P＞0.05）；12、24个月的复发率比较均有显著差异（P＜0.05）。两组患者术后12、24个月的无复发生存率比较均有显著差异（P＜0.05）；两组患者术后6个月、12个月总体生存率比较无显著差异（P＞0.05），观察组术后24个月总体生存率显著高于对照组（P＜0.05）。观察组患者术后社会功能评分、心理功能评分、躯体功能评分均显著高于对照组（P＜0.05）。结论:TURBT术后联合静脉化疗治疗肌层浸润性膀胱癌效果显著，术后并发症少，恢复快，可以提高患者术后生活质量，适合临床长期推广应用。

Comparative study on the clinical efficacy of TURBT combined with chemotherapy and radical cystectomy for myometrial invasive bladder cancer

Objective:To analyze and compare the clinical effect and quality of life of transurethral bladder tumor (TURBT) combined with intravenous chemotherapy and radical cystectomy in the treatment of myometrial invasive bladder cancer.Methods:A retrospective analysis was made of 73 patients with myometrial invasive bladder cancer in our hospital from July 2014 to March 2017.39 patients underwent intravenous chemotherapy after TURBT as the observation group and 34 patients underwent radical cystectomy as the control group.The perioperative indicators,the occurrence of complications,the recurrence and survival within 2 years of follow-up,and the quality of life after operation were observed and compared between the two groups.Results:The operation time,intraoperative bleeding volume and hospitalization time in the observation group were significantly lower than those in the control group (P＜0.05).The total incidence of complications was 10.3% (4/39) in the observation group and 32.4% (11/34) in the control group.There was a significant difference between the two groups (P＜0.05).There was no significant difference in the recurrence rate between the observation group and the control group in 3 months and 6 months after operation (P＞0.05),and there was significant difference in the recurrence rate between 12 and 24 months after operation (P＜0.05).There was no significant difference in the overall survival rate of 6 months and 12 months after operation between the two groups (P＞0.05).The overall survival rate of 24 months after operation in the observation group was significantly higher than that in the control group (P＜0.05).The scores of social function,psychological function and physical function in the observation group were significantly higher than those in the control group (P＜0.05).Conclusion:TURBT combined with intravenous chemotherapy is effective in the treatment of myometrial invasive bladder cancer with fewer complications and faster recovery.It can improve the quality of life of patients after TURBT and is suitable for clinical application for a long time.