临床外科杂志 ›› 2022, Vol. 30 ›› Issue (12): 1187-1190.doi: 10.3969/j.issn.1005-6483.2022.12.025

• 论著 • 上一篇    下一篇

经尿道等离子电切镜逆行黏膜下膀胱肿瘤整块剜切术对非肌层浸润性膀胱癌病人的出血量及氧化应激因子的影响 

  

  1. 363000 联勤保障部队第909医院暨厦门大学附属东南医院泌尿外科
  • 收稿日期:2022-03-17 接受日期:2022-03-17 出版日期:2022-12-20 发布日期:2023-01-20
  • 通讯作者: 李金雨,Email:lijinyu0920@163.com

Effect of transurethral plasma ERBT on blood loss and oxidative stress factors in patients with NMIBC

  1. The 909th Hospital of the Security Department and  Southeast Hospital Affiliated to Xiamen University 363000,China
  • Received:2022-03-17 Accepted:2022-03-17 Online:2022-12-20 Published:2023-01-20

摘要: 目的 探讨经尿道等离子电切镜逆行黏膜下膀胱肿瘤整块剜切术(ERBT)对非肌层浸润性膀胱癌(NMIBC)病人出血量和机体氧化应激的影响。方法 2019年1月~2021年1月在我院接受手术治疗的NMIBC病人92例,根据手术方式将其分为经尿道膀胱肿瘤电切术(TURBT)组(53例)和ERBT组(39例)。比较两组手术相关指标、手术并发症发生情况、手术前后排尿功能及血液氧化应激指标变化情况。结果 两组手术时间、导尿管留置时间比较,差异无统计学意义(P>0.05),ERBT组病人术中出血量少于TURBT组,膀胱冲洗时间和住院时间均短于TURBT组,差异均有统计学意义(P<0.05)。ERBT组闭孔神经反射发生率低于TURBT组,差异有统计学意义(P<0.05),膀胱穿孔和尿路感染发生率低于TURBT组,但差异无统计学意义(P>0.05)。ERBT组病人术后1个月最大尿流率、最大逼尿肌压力均高于TURBT组,残余尿量低于TURBT组,差异有统计学意义(P<0.05)。术后7天,ERBT组病人血清谷胱甘肽过氧化物酶、超氧化物歧化酶和血清总抗氧化活性均高于TURBT组,血清丙二醛低于TURBT组,差异均有统计学意义(P<0.05)。结论经尿道等离子ERBT术能减少NMIBC术中出血量,缩短术中膀胱冲洗时间,缓解手术引起的机体氧化应激反应,降低闭孔神经反射发生率。

关键词: 黏膜下膀胱肿瘤整块剜切术, 非肌层浸润性膀胱癌, 经尿道膀胱肿瘤电切术, 术中出血量, 氧化应激

Abstract: Objective To investigate the effect of transurethral plasma resectoscope retrograde submucosal enucleation of bladder tumor(ERBT) on blood loss and oxidative stress in patients with non myometrial invasive bladder cancer(NMIBC).Methods92 patients with NMIBC who underwent surgery in our hospital from January 2019 to January 2021 were selected as the research object.The data of the patients were analyzed retrospectively.According to the operation method,they were divided into transurethral resection of bladder tumor(TURBT) group(n=53) and erbt group(n=39).The changes of operation related indexes,operation complications,micturition function and blood oxidative stress indexes before and after operation were recorded and compared between the two groups.〖WTHZ〗Results〓〖WTBZ〗There was no significant difference in the operation time and catheter retention time between the two groups(P>0.05).The amount of intraoperative bleeding in erbt group was significantly less than that in TURBT group,and the bladder flushing time and hospital stay were significantly shorter than that in TURBT group(P<0.05).The incidence of obturator nerve reflex in erbt group was significantly lower than that in TURBT group(P<0.05),and the incidence of bladder perforation and urinary tract infection were also lower than that in TURBT group,but there was no significant difference(P>0.05).The maximum urinary flow rate(Qmax) and maximum detrusor pressure(MDP) in erbt group were significantly higher than those in TURBT group,and the residual urine volume(PVR) was significantly lower than that in TURBT group(P<0.05).7 days after operation,serum glutathione peroxidase(GSH PX),superoxide dismutase(SOD) and total antioxidant activity(AOA) in erbt group were significantly higher than those in TURBT group,while serum malondialdehyde(MDA) was significantly lower than that in TURBT group(P<0.05).Conclusion Transurethral plasma erbt can significantly reduce the amount of intraoperative bleeding in patients with NMIBC,shorten the time of intraoperative bladder flushing,effectively alleviate the body's oxidative stress response caused by surgery,and reduce the incidence of obturator nerve reflex,which is conducive to the postoperative prognosis of patients.

Key words: enucleation of bladder tumor, non myometrial invasive bladder cancer, transurethral resection of bladder tumor, intraoperative blood loss, oxidative stress

[1] 姚宝春 邓大溢 方强 陈士洲. 激光与电切术治疗非肌层浸润性膀胱癌的疗效及应激反应程度比较[J]. 临床外科杂志, 2022, 30(6): 579-582.
[2] 闫照虹 赵建奎. 肠梗阻病人麻醉方案优化及对肠道屏障功能、氧化应激和抑制炎症影响的差异性[J]. 临床外科杂志, 2022, 30(12): 1143-1146.
[3] 姜小琴 李惠珍. 经尿道膀胱肿瘤电切术同期经尿道前列腺电切术治疗非浸润性膀胱癌伴良性前列腺增生的安全性及有效性研究[J]. 临床外科杂志, 2021, 29(9): 872-875.
[4] 李连红, 施柳辉, 施飞等. 非肌层浸润性膀胱癌病人在膀胱灌注化疗期间性功能状况的影响因素分析[J]. 临床外科杂志, 2021, 29(4): 372-375.
[5] 张锡凤 陈玲玲 安宏嫱 吴世焕 刘娇 周力. 不同剂量右美托咪定对小儿腹部手术后躁动与氧化应激反应的影响[J]. 临床外科杂志, 2021, 29(11): 1083-1085.
[6] 黄韬 王淼 王勇军等 . 第二次经尿道膀胱肿瘤电切术预防高危非肌层浸润性膀胱癌术后肿瘤复发的临床研究 [J]. 临床外科杂志, 2013, 21(2): 98-100.
[7] 胥金斌 徐建林 邵建中 . 经尿道二次电切治疗非肌层浸润性膀胱肿瘤的临床研究 [J]. 临床外科杂志, 2013, 21(2): 103-105.
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