中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
20期
4-6
,共3页
刘安%郭亚雄%高旭%何海宝%王刚%张建勋
劉安%郭亞雄%高旭%何海寶%王剛%張建勛
류안%곽아웅%고욱%하해보%왕강%장건훈
膀胱肿瘤%复发%外科手术
膀胱腫瘤%複髮%外科手術
방광종류%복발%외과수술
Urinary bladder neoplasms%Recurrence%Surgical procedures,operative
目的 探讨经尿道二次电切术治疗非肌层浸润性膀胱癌术后复发的作用.方法 经尿道电切术治疗非肌层浸澜性膀胱癌患者120例,采取随机机械抽样方法分成两组,每组60例,试验组于首次经尿道电切术后4周行经尿道二次电切术,外加丝裂霉素膀胱灌注化疗；对照组首次经尿道电切术后加丝裂霉素膀胱灌注化疗.两组术后每3个月行膀胱镜复检,随访6～34 (18.6±6.5)个月,对比其术后肿瘤复发情况.结果 在随访期内,试验组复发率明显低于对照组[21.7％(13/60)比63.3％ (38/60)],差异有统计学意义(P＜0.01).所有复发患者中,以高级别肿瘤(G2、G3级)的复发为主,试验组高级别肿瘤复发率明显低于对照组[26.2％(11/42)比70.0％(35/50)],差异有统计学意义(P＜0.01).结论 经尿道二次电切术可以降低非肌层浸润性膀胱癌(尤其是高级别肿瘤)的术后复发率,可以更准确地进行肿瘤分期和发现残存肿瘤,在临床治疗上是有应用价值的.
目的 探討經尿道二次電切術治療非肌層浸潤性膀胱癌術後複髮的作用.方法 經尿道電切術治療非肌層浸瀾性膀胱癌患者120例,採取隨機機械抽樣方法分成兩組,每組60例,試驗組于首次經尿道電切術後4週行經尿道二次電切術,外加絲裂黴素膀胱灌註化療；對照組首次經尿道電切術後加絲裂黴素膀胱灌註化療.兩組術後每3箇月行膀胱鏡複檢,隨訪6～34 (18.6±6.5)箇月,對比其術後腫瘤複髮情況.結果 在隨訪期內,試驗組複髮率明顯低于對照組[21.7％(13/60)比63.3％ (38/60)],差異有統計學意義(P＜0.01).所有複髮患者中,以高級彆腫瘤(G2、G3級)的複髮為主,試驗組高級彆腫瘤複髮率明顯低于對照組[26.2％(11/42)比70.0％(35/50)],差異有統計學意義(P＜0.01).結論 經尿道二次電切術可以降低非肌層浸潤性膀胱癌(尤其是高級彆腫瘤)的術後複髮率,可以更準確地進行腫瘤分期和髮現殘存腫瘤,在臨床治療上是有應用價值的.
목적 탐토경뇨도이차전절술치료비기층침윤성방광암술후복발적작용.방법 경뇨도전절술치료비기층침란성방광암환자120례,채취수궤궤계추양방법분성량조,매조60례,시험조우수차경뇨도전절술후4주행경뇨도이차전절술,외가사렬매소방광관주화료；대조조수차경뇨도전절술후가사렬매소방광관주화료.량조술후매3개월행방광경복검,수방6～34 (18.6±6.5)개월,대비기술후종류복발정황.결과 재수방기내,시험조복발솔명현저우대조조[21.7％(13/60)비63.3％ (38/60)],차이유통계학의의(P＜0.01).소유복발환자중,이고급별종류(G2、G3급)적복발위주,시험조고급별종류복발솔명현저우대조조[26.2％(11/42)비70.0％(35/50)],차이유통계학의의(P＜0.01).결론 경뇨도이차전절술가이강저비기층침윤성방광암(우기시고급별종류)적술후복발솔,가이경준학지진행종류분기화발현잔존종류,재림상치료상시유응용개치적.
Objective To investigate the effect of secondary transurethral electrocision for recurrent superficial bladder cancer.Methods One hundred and twenty patients with recurrent superficial bladder cancer were divided into experiment group and control group by random mechanical sampling method with 60 cases of each.Experiment group underwent secondary transurethral electrocision at 4 weeks after initial transurethral electrocision and received mitomycin bladder perfusion chemotherapy,control group patients underwent initial transurethral electrocision and received mitomycin bladder perfusion chemotherapy.The two groups' follow-up cystoscopy at 3-month intervals,the follow-up time was 6-34 (18.6 ± 6.5) months,the recurrence was compared between each other.Results Within the follow-up period,the recurrence rate in experiment group was significantly lower than that in control group [21.7％(13/60) vs.63.3％(38/60),P＜0.01].Of all the recurrent patients,high grade rumor (G2 and G3 grade) was mainly,the recurrence rate of high grade tumor in experiment group was significantly lower than that in control group [26.2％ (11/42) vs.70.0％(35/50),P ＜ 0.01].Conclusions Secondary transurethral electrocision can reduce the recurrence rate of superficial bladder cancer (especially for the high grade tumor),it can exactly make the classification of malignant tumors and find residual tumor.So it is valuable in the clinical treatment.
