【摘要】 目的 比较“推挑式”铥激光膀胱肿瘤整体剜除术(TmLRBT)与等离子膀胱肿瘤电切术(TURBT)处理非肌层浸润性膀胱癌(NMIBC)的疗效与安全性。方法 分析2018年1月至2020年6月我院99例NMIBC患者的临床资料，其中行“推挑式”TmLRBT 50例，行TURBT 49例，比较两组手术时间、术中出血量、膀胱冲洗时间、保留导尿时间、术后住院时间、术中并发症、尿道狭窄发生及肿瘤复发情况。结果 TmLRBT组手术时间(38.56±8.51)min, TURBT组(36.79±9.05)min,差异无统计学意义(P>0.05)。TmLRBT组术中出血量(7.59±3.34)ml,膀胱冲洗时间(1.05±0.82)d,术后留置尿管时间(3.87±2.77)d,术后住院时间(4.96±2.38)d,显著低于TURBT组的(11.84±4.17)ml、(3.23±1.35)d、(5.69±3.01)d、(6.56±2.42)d,差异有统计学意义(P<0.05)。术后TmLRBT组无闭孔神经反射及膀胱穿孔，显著低于TURBT组的14.29%及10.20%(P<0.05);术后发生尿道狭窄两组差异无统计学意义(P>0.05);在12个月肿瘤复发率中，TmLRBT组发生2例(4.00%),TURBT组发生8例(16.33%),差异有统计学意义(P<0.05)。结论 TmLRBT与TURBT都是处理NMIBC安全可靠的手术方式，“推挑式”TmLRBT在安全性及疗效上更有优势，值得推广。更多还原

【Abstract】 Objective To compare safety and efficacy of push and pick thulium laser enucleation of bladder tumor(TmLRBT)and plasma resection of bladder tumor(TURBT)in the treatment of non-muscle invasive bladder cancer(NMIBC).Methods Clinical data of 99 cases of NMIBC from January 2018 to June 2020 were retrospectively analyzed, including 50 cases of push and pick TmLRBT and 49 cases of TURBT.The operation time, surgical bleeding, intraoperative complications, bladder washing time, retention catheterization time, postoperative hospitalization time, postoperative urethral stricture and tumor recurrence were compared.Results Operation time of TmLRBT group was(38.56±8.51)min, and that of TURBT group was(36.79±9.05)min.There was no significant difference(P>0.05).In TmLRBT group, intraoperative bleeding volume(7.59±3.34)ml, bladder washing time(1.05±0.82)d, postoperative indwelling urinary catheter time(3.87±2.77)d, and postoperative hospitalization time(4.96±2.38)d were significantly lower than those in TURBT group(11.84±4.17)ml,(3.23±1.35)d,(5.69±3.01)d and(6.56±2.42)d)with significant differences(P<0.05).There was no obturator nerve reflex and bladder perforation in TmLRBT group after operation, which was significantly lower than 14.29% and 10.20% in TURBT group(P<0.05).There was no significant difference in urethral stricture(P>0.05).In the 12-month tumor recurrence rate, 2 cases(4.00%)occurred in TmLRBT group and 8 cases(16.33%)occurred in TURBT group with significant difference(P<0.05).Conclusion Both TmLRBT and TURBT would be safe and reliable surgical methods for the treatment of NMIBC.The push and pick TmLRBT would have more advantages in safety and efficacy, and is worth popularizing.更多还原