标题：经尿道等离子针状电极剜除术治疗非浸润性膀胱癌疗效观察

      作者：耿爱民，林西斌    长安医院泌尿外科，陕西 西安 710016

      卷次： 2020年31卷10期

      【摘要】 目的 探讨经尿道等离子针状电极剜除手术治疗非浸润性膀胱癌的临床疗效。方法 选取长安医院泌尿外科2016年1月至2018年12月收治的90例非浸润性膀胱癌患者为研究对象，按照随机数表法将患者对照组和观察组，每组45例。对照组患者采用激光手术治疗，观察组患者则采用经尿道等离子针状电极剜除术治疗。术后比较两组患者的手术时间、膀胱冲洗时间、术中失血量、尿管留置时间及住院时间等临床指标，并比较两组患者术后并发症、术后二次活检阳性率及预后情况。结果 观察组和对照组患者的手术时间[(24.48±4.61) min vs(35.36 ± 7.31) min]、术中失血量 [(243.18 ± 10.63) mL vs (403.64 ± 20.97) mL]、膀胱冲洗时间 [(19.25 ± 2.17) min vs(34.37±6.03) min]、尿管留置时间[(34.37±6.43) h vs (59.82±8.28) h]、住院时间[(4.27±0.64) d vs (6.15±1.53) d]比较，观察组明显少于或短于对照组，差异均有统计学意义(P<0.05)；观察组患者的并发症发生率、膀胱穿孔率和膀胱反射率分别为17.78%、2.22%和2.22%，明显低于对照组的46.67%、13.33%和15.56%，差异均有统计学意义(P<0.05)；观察组患者术后二次活检阳性率及出院后3个月复发率分别为4.44%、2.22%，明显低于对照组的28.89%、15.56%，差异均有统计学意义(P<0.05)。结论 经尿道等离子针状电极剜除术治疗非浸润性膀胱癌临床疗效显著，其可缩短手术时间，降低复发率，改善预后，安全性高，值得临床推广应用。
      【关键词】 针状电极；激光手术；非浸润性膀胱癌；剜除术；安全性
      【中图分类号】 R737.14 【文献标识码】 A 【文章编号】 1003—6350（2020）10—1266—03

Application of transurethral plasma needle electrode enucleation in the treatment of non-invasive bladdercancer.
GENG Ai-min, LIN Xi-bin. Department of Urology, Chang'an Hospital, Xi'an 710016, Shaanxi, CHINA
【Abstract】 Objective To explore the clinical effect of transurethral plasma needle electrode enucleation in thetreatment of non-invasive bladder cancer. Methods From January 2016 to December 2018, 90 patients with non-invasivebladder cancer who admitted to Department of Urology, Chang'an Hospital were selected and divided into the controlgroup and the observation group according to the random number table method, with 45 patients in each group. The pa-tients in the control group were treated by laser surgery, and patients in the observation group were treated by transurethralplasma needle electrode enucleation. After surgery, the operation time, bladder washing time, intraoperative blood loss, in-dwelling time of urinary catheter, and hospitalization time were compared between the two groups. The incidence of post-operative complications, the positive rate of second biopsy, and prognosis were also compared. Results The operationtime, intraoperative blood loss, bladder flushing time, catheter retention time, hospital stay time of the the observationgroup were (24.48±4.61) min, (243.18±10.63) mL, (19.25±2.17) min, (34.37±6.43) h, (4.27±0.64) d, respectively, whichwere significantly less than or shorter than corresponding (35.36 ± 7.31) min, (403.64 ± 20.97) mL, (34.37 ± 6.03) min,(59.82±8.28) h, (6.15±1.53) d of the control group (all P<0.05); the complication rate, bladder perforation rate, and blad-der reflectivity of the observation group were 17.78%, 2.22% and 2.22%, respectively, which were significantly lowerthan corresponding 46.67%, 13.33%, 15.56% of the control group (all P<0.05); the positive rate of the second biopsyand the recurrence rate of the three months after discharge in the observation group were 4.44% and 2.22%, which weresignificantly lower than 28.89% and 15.56% in the control group (P<0.05). Conclusion Transurethral plasma needleelectrode enucleation is effective in the treatment of non-invasive bladder cancer, and it can shorten the operation time,reduce the recurrence rate, improve the prognosis, and has high safety, which is worthy of clinical application.
      【Key words】 Needle electrode; Laser surgery; Non-invasive bladder cancer; Enucleation; Safety