根治性经尿道膀胱肿瘤电切术治疗老年肌层浸润性膀胱癌的临床效果

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　　[摘要]目的 探索根治性经尿道膀胱肿瘤电切术治疗老年肌层浸润性膀胱癌的临床效果。方法 选取2016年1月22日～2019年1月22日我院收治的90例老年肌层浸润性膀胱癌患者作为研究对象，按照数据库奇偶数随机方法将其分为对照组（45例）与观察组（45例）。对照组患者采用膀胱部分切除术治疗，观察组患者采用根治性经尿道膀胱肿瘤电切术治疗。比较两组患者的并发症总发生率、术中出血量、手术时间、住院时间、切缘阴性率，3、6个月内复发率及治疗前后健康相关生活质量（HRQOL）、膀胱癌特异性量表（FACT-BL）评分。结果 观察组患者的并发症总发生率（2.22%）、3个月内复发率（0.00%）、6个月内复发率（2.22%）均低于对照组（26.67%、8.89%、15.56%），差异有统计学意义（P<0.05）。观察组患者的术中出血量[（43.68±5.79）ml]少于对照组[（56.19±7.18）ml]，差异有统计学意义（P<0.05）。观察组患者的手术时间[（23.41±2.33）min]、住院时间[（7.89±2.13）d]均短于对照组[（38.96±5.46）min、（9.75±2.54）d]，差异有统计学意义（P<0.05）。观察组患者的切缘阴性率（97.78%）高于对照组（73.33%），差异有统计学意义（P<0.05）。观察组患者治疗后的HRQOL評分[（56.79±6.22）分]、FACT-BL评分[（84.63±7.46）分]均分别高于对照组[（42.38±4.54）、（72.51±5.11）分]，差异有统计学意义（P<0.05）。结论 对老年肌层浸润性膀胱癌患者实施根治性经尿道膀胱肿瘤电切术治疗的效果显著。
　　[关键词]根治性经尿道膀胱肿瘤电切术;膀胱部分切除术;肌层浸润性膀胱癌;复发率;切缘阴性率
　　[Abstract] Objective To explore the clinical effect of radical transurethral resection of bladder tumor in the treatment of senile muscular invasive bladder cancer. Methods Ninety patients with senile muscular invasive bladder cancer treated in our hospital from January 22， 2016 to January 22， 2019 were selected as the research subjects， and they were divided into control group （45 cases） and observation group （45 cases） according to the database odd and even random method. Patients in the control group were treated with partial bladder resection， and patients in the observation group were treated with radical transurethral resection of bladder tumor. The total incidence rate of complications， intraoperative blood loss， operation time， hospitalization time， resection margin negative rate， recurrence rates within 3 and 6 months， health-related quality of life （HRQOL） and function assesment of cancer therapy-bladder cancer form （FACT-BL） scores before and after treatment were compared between the two groups. Results The total incidence rate of complications in the observation group （2.22%）， the recurrence rate within 3 months （0.00%）， and the recurrence rate within 6 months （2.22%） were lower than those in the control group （26.67%， 8.89%， 15.56%）， and the differences were statistically significant （P<0.05）. The intraoperative blood loss of the observation group （[43.68±5.79] ml） was less than that of the control group （[56.19±7.18] ml）， and the difference was statistically significant （P<0.05）. The operation time （[23.41±2.33] min） and hospitalization time （[7.89±2.13] d） of the observation group were shorter than those of the control group （[38.96±5.46] min， [9.75±2.54] d）， and the differences were statistically significant （P<0.05）. The resection margin negative rate of patients in the observation group （97.78%） was higher than that in the control group （73.33%）， and the difference was statistically significant （P<0.05）. The HRQOL score （[56.79±6.22] points） and FACT-BL score （[84.63±7.46] points） of the observation group were higher than those of the control group （[42.38±4.54]， [72.51±5.11] points）， and the differences were statistically significant （P<0.05）. Conclusion The effect of radical transurethral resection of bladder tumor is significant in the treatment of senile patients with muscular invasive bladder cancer
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