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目的阐明高能聚焦超声刀加经尿道气化术联合应用治疗晚期膀胱癌的优点,适应症和临床效果。方法应用高能聚焦超声刀(HIFU)加经尿道气化术(TV-Bt)联合治疗12例晚期膀胱癌。先用高能取焦超声刀瞄准膀胱壁深层及膀胱壁外的肿瘤社照射,然后行经尿道气化电切术将突间膀胱腔内的癌社切除。术后酌情再补充作1～2次HIFU治疗。对远处转移社(如肋骨等)可同步行小剂量放射治疗。结果治疗后3月随访,所有12例患者临床症状明显改善或消失,B超、CT和膀胱镜检查均未见肿瘤复发。结论HIFU加TV-Bt联合应用治疗晚期膀胱癌具有微创、恢复快、适应症广、操作简便、安全有效、并发症少等众多优点,尤其适宜于年老体弱、已失去膀胱全切时机的晚期膀胱癌患者。它是有效治疗晚期膀胱癌的一个新方法。
Objective To elucidate the advantages, indications and clinical effects of high energy focused ultrasound knife combined with transurethral vaporization in the treatment of advanced bladder cancer. Methods Twelve patients with advanced bladder cancer were treated with HIFU combined with transurethral vaporization (TV-Bt). First use of high-energy defocus scalpel aimed at the deep bladder wall and the tumor wall outside the bladder club irradiation, and then through the urethral vaporization of the resection of the bladder cancer chamber excision. After surgery as appropriate, supplemented for 1 or 2 times HIFU treatment. Transfer to distant places (such as ribs, etc.) can be synchronized with low-dose radiation therapy. Results After 3 months of follow-up, the clinical symptoms of all 12 patients were significantly improved or disappeared. No tumor recurrence was found in B-ultrasound, CT and cystoscopy. Conclusions The combination of HIFU plus TV-Bt in the treatment of advanced bladder cancer has many advantages such as minimally invasive, rapid recovery, wide indications, simple and convenient operation, safe and effective, few complications and so on. Of advanced bladder cancer patients. It is a new method for effective treatment of advanced bladder cancer.