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目的:评价经尿道1 470nm半导体激光治疗表浅性膀胱肿瘤的疗效,并与经尿道膀胱肿瘤电切术(TURBT)的疗效和安全进行比较。方法:随机选取61例膀胱肿瘤患者按手术方式分为1 470nm半导体激光组(27例)及TURBT组(34例),比较两组平均手术时间、术中出血量、闭孔神经反射发生例数、膀胱穿孔例数、术后平均住院时间及术后肿瘤复发率等指标,并比较其临床疗效。结果:两组术后平均住院时间、术后6个月肿瘤复发率的差异无统计学意义(P>0.05),术后15个月肿瘤复发率的差异有统计学意义(P<0.05);TURBT组手术时间少于半导体激光组(P<0.05);而半导体激光组的术中出血量、闭孔神经反射发生例数、膀胱穿孔例数明显少于TURBT组(P<0.05)。结论:经尿道1 470nm半导体激光治疗表浅性膀胱肿瘤与TURBT短期临床疗效相似,中期疗效更优。经尿道1 470nm激光切除膀胱肿瘤操作简单,疗效安全可靠,创伤小,术中及术后无严重并发症,是膀胱浅表性肿瘤治疗的一种理想手法,值得临床推广应用。
PURPOSE: To evaluate the efficacy of transurethral 1 470 nm semiconductor laser in the treatment of superficial bladder tumors and to compare the efficacy and safety of transurethral resection of the bladder tumor (TURBT). Methods: Totally 61 patients with bladder cancer were randomly divided into 1 470 nm semiconductor laser group (27 cases) and TURBT group (34 cases). The mean operative time, intraoperative blood loss and the number of obturator nerve reflex , The number of bladder perforation, average postoperative hospital stay and postoperative tumor recurrence rate and other indicators, and compare their clinical efficacy. Results: The average postoperative hospital stay and the recurrence rate at 6 months postoperatively were not statistically different (P> 0.05). The recurrence rates at 15 months after operation were significantly different (P <0.05). The operation time of the TURBT group was less than that of the semiconductor laser group (P <0.05). The intraoperative blood loss, the number of obturator reflex and the number of bladder perforation in the semiconductor laser group were significantly less than those in the TURBT group (P <0.05). Conclusion: Transurethral resection of bladder cancer with 1470nm semiconductor laser is similar to the short-term clinical efficacy of TURBT, and the mid-term curative effect is better. Transurethral resection of the bladder tumor by 1 470nm laser is simple, safe and reliable, with minimal trauma and no serious intraoperative and postoperative complications. It is an ideal treatment for superficial bladder tumors and is worthy of clinical application.