中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
4期
372-374
,共3页
王珂%唐来坤%汪祖林%宋立%田峰%俞仲伟%屈维龙%吴凤金%骆德兴
王珂%唐來坤%汪祖林%宋立%田峰%俞仲偉%屈維龍%吳鳳金%駱德興
왕가%당래곤%왕조림%송립%전봉%유중위%굴유룡%오봉금%락덕흥
膀胱癌%膀胱出口梗阻
膀胱癌%膀胱齣口梗阻
방광암%방광출구경조
Bladder Cancer%Bladder outlet obstruction
目的 探讨膀胱出口不全梗阻在膀胱癌发病和复发中的作用.方法 回顾性分析2001年1月至2008年11月我院收治的前列腺增生患者581例的临床资料,将其中接受手术治疗的39例随机分为同期经尿道等离子双极前列腺电切术(TUPKP)+经尿道膀胱肿瘤电切术(TURBT)组(23例)及单纯行TURBT 组(16例),对2组分别行TUPKP+TURBT和TURBT,随访12～36个月,观察术后2组的膀胱癌复发率及复发时间,同时观察经耻骨上膀胱肿瘤切除术的患者膀胱颈口狭窄情况.观察2组术前国际前列腺症状评分(IPSS),最大尿流率(Qmax),残余尿量(RUV),术后IPSS、Qmax、RUV及术后1年内膀胱肿瘤复发率.结果 TUPKP+TURBT组术后IPSS、Qmax、RUV分别为(13±8)分、(19.3±9.5)ml/s、(18.7±11.6)ml,TURBT组分别为(20±7)分、(11.5±8.2)ml/s、(42.9±13.7)ml,2组相比差异有统计学意义(t值分别为3.013、15.190、4.532,P均<0.05).TUPKP+TURBT组1年内膀胱癌复发率34.78%(8/23)明显低于TURBT组的68.75%(11/16)(χ~2 值为4.358,P<0.05).结论 膀胱出口不全梗阻与膀胱癌的发生发展和复发有着密切的关系,在行膀胱癌手术时,需考虑到同期解除前列腺增生或其他原因所致的膀胱出口不全梗阻.
目的 探討膀胱齣口不全梗阻在膀胱癌髮病和複髮中的作用.方法 迴顧性分析2001年1月至2008年11月我院收治的前列腺增生患者581例的臨床資料,將其中接受手術治療的39例隨機分為同期經尿道等離子雙極前列腺電切術(TUPKP)+經尿道膀胱腫瘤電切術(TURBT)組(23例)及單純行TURBT 組(16例),對2組分彆行TUPKP+TURBT和TURBT,隨訪12～36箇月,觀察術後2組的膀胱癌複髮率及複髮時間,同時觀察經恥骨上膀胱腫瘤切除術的患者膀胱頸口狹窄情況.觀察2組術前國際前列腺癥狀評分(IPSS),最大尿流率(Qmax),殘餘尿量(RUV),術後IPSS、Qmax、RUV及術後1年內膀胱腫瘤複髮率.結果 TUPKP+TURBT組術後IPSS、Qmax、RUV分彆為(13±8)分、(19.3±9.5)ml/s、(18.7±11.6)ml,TURBT組分彆為(20±7)分、(11.5±8.2)ml/s、(42.9±13.7)ml,2組相比差異有統計學意義(t值分彆為3.013、15.190、4.532,P均<0.05).TUPKP+TURBT組1年內膀胱癌複髮率34.78%(8/23)明顯低于TURBT組的68.75%(11/16)(χ~2 值為4.358,P<0.05).結論 膀胱齣口不全梗阻與膀胱癌的髮生髮展和複髮有著密切的關繫,在行膀胱癌手術時,需攷慮到同期解除前列腺增生或其他原因所緻的膀胱齣口不全梗阻.
목적 탐토방광출구불전경조재방광암발병화복발중적작용.방법 회고성분석2001년1월지2008년11월아원수치적전렬선증생환자581례적림상자료,장기중접수수술치료적39례수궤분위동기경뇨도등리자쌍겁전렬선전절술(TUPKP)+경뇨도방광종류전절술(TURBT)조(23례)급단순행TURBT 조(16례),대2조분별행TUPKP+TURBT화TURBT,수방12～36개월,관찰술후2조적방광암복발솔급복발시간,동시관찰경치골상방광종류절제술적환자방광경구협착정황.관찰2조술전국제전렬선증상평분(IPSS),최대뇨류솔(Qmax),잔여뇨량(RUV),술후IPSS、Qmax、RUV급술후1년내방광종류복발솔.결과 TUPKP+TURBT조술후IPSS、Qmax、RUV분별위(13±8)분、(19.3±9.5)ml/s、(18.7±11.6)ml,TURBT조분별위(20±7)분、(11.5±8.2)ml/s、(42.9±13.7)ml,2조상비차이유통계학의의(t치분별위3.013、15.190、4.532,P균<0.05).TUPKP+TURBT조1년내방광암복발솔34.78%(8/23)명현저우TURBT조적68.75%(11/16)(χ~2 치위4.358,P<0.05).결론 방광출구불전경조여방광암적발생발전화복발유착밀절적관계,재행방광암수술시,수고필도동기해제전렬선증생혹기타원인소치적방광출구불전경조.
Objective To investigate the role of the bladder outlet obstruction in the bladder cancer incidence and recurrence.Methods From Jan.2001 to Jan.2008 in our hospital,fourty-one cases of benign prostatic hyperplasia patients,with bladder cancer,were selected from 581 cases of benign prostatic hyperplasia patients,39 of them were randomly divided into two groups:One group were treated by surgery of bipolar transurethral plasma kinetic of prostatectomy(TUPKP) and transurethral resection of bladder tumor(TURBT) at the same time (observe group:23 cases),and the other group were treated by surgery of TURBT(control group:16 cases).All the patients were followed up for 12 to 36 months.Recurrence rate and recurrence time,as well as the suprapubic bladder tumor surgery in patients with stenosis of the bladder neck was also observed.Preoperative International Prostate Symptom Score (IPSS),maximum flow rate (Qmax),residual urine (RUV) and postoperative IPSS,Qmax,and RUV were tested for the difference between the two groups using t test.The variability of relapse rate after one year between the two groups were analyzed by χ~2 test.All statistical analysis was performed in SPSS 11.5.Results Postoperative IPSS,Qmax,RUV were (13±8)points,(19.3±9.5)ml/s,(18.7±11.6)ml in observe group and (20±7)points,(11.5±8.2)ml/s,(42.9±13.7)ml in control group (P<0.05),and the recurrence rate in 1 year was 34.78%(8/23) and 68.75% (11/16) in the two groups (P<0.05).Conclusions There is close correlation between bladder cancer and bladder outlet obstruction.The patients of bladder cancer combined with bladder outlet obstruction should be discharged bladder outlet obstruction at the same time.
