【摘要】 目的:对比分析经尿道双极等离子针状电极与环状电极治疗非肌层浸润性膀胱癌的疗效。方法:选取2016年9月～2017年8月经泌尿系彩超、膀胱镜检查并行病理活检确诊为尿路上皮癌,CTU检查提示无膀胱壁外浸润且上尿路无侵及的中等大小(直径1.0～3.0cm)膀胱肿瘤患者66例纳入研究样本,按照住院顺序随机分为2组,其中针状电极组33例,环状电极组33例。将两组手术出血量、尿管留置时间、住院时间、闭孔神经反射发生率、病理标本深度及术后随访4～17个月的复发率进行统计学分析。结果:66例手术均由同一位高年资医师完成,手术采用全身麻醉,均未行闭孔神经区域阻滞,分别以针状电极与环状电极完整切除肿瘤,瘤体标本完整。比较两组手术出血量、尿管留置时间、住院时间、闭孔神经反射发生率、病理标本深度及术后随访4～17个月的复发率,针状电极组均小于环状电极组(P<0.05)。结论:经尿道等离子针状电极整块切除术治疗非肌层浸润性膀胱肿瘤具有非常大的潜力,具有安全有效,技术及设备门槛低,精准整块切除、减少转移及种植、损伤小,闭孔神经反射少,利于精确病理分期等优点。更多还原

【Abstract】 Objective:To compare the efficacy of transurethral bipolar plasma needle electrode vs.annular electrode in the treatment of non muscle-invasive bladder cancer.Methods:From September 2016 to August 2017,66 cases of urothelial carcinoma admitted in our hospital were diagnosed by urological color Doppler ultrasound and cystoscopy parallel biopsy.The CTU examination suggested no invasion of the bladder wall and no invasion of the upper urinary tract(diameter of 1.0-3.0 cm),and according to the order of hospitalization,the patients were divided into 2 groups,including needle electrode group(33 cases)and ring electrode group(33 cases).The surgical bleeding,catheter indwelling time,hospitalization time,the incidence of obturator nerve reflex,the depth of pathological specimen,and the recurrence rate during the posotoperative follow-up of 4-17 months were statistically analyzed.Results:All operations of the 66 cases were performed successfully under the geneal anesthesia by the same senior resident physician.No block of the obturator nerve area was performed.The tumor was completely removed with needle electrode and ring electrode,and the tumor specimen was complete.The rate of bleeding,indwelling time of urethral catheter,hospital stay,the incidence of obturator nerve reflex,the depth of pathological specimen,and the recurrence rate during the postoperative follow-up of 4-17 months were compared between the two groups.Those in needle electrode group were superior to the ring electrode group(P<0.05).Conclusions:Pin-shaped bipolar plasmakinetic electrode used in transurethral en bloc resection of non muscle-invasive bladder urothelial carcinoma is safe and effective,has low threshold of the technology and equipment,can precisely and completely remove the tumor and reduce the metastasis and planting,has little injury and obturator nerve reflex,and is conducive to accurate staging,etc.更多还原