经尿道钬激光整块切除术对高危老年非肌层浸润性膀胱癌患者术后恢复、炎症反应及预后的影响

Effects of transurethral holmium laser bulk resection on postoperative recovery,inflammatory response and prognosis in high-risk NMIBC patients

中文关键词: 老年  非肌层浸润性膀胱癌  高危  经尿道钬激光整块切除术  炎症  预后

英文关键词: elderly  non-muscle invasive bladder cancer  high-risk  transurethral holmium laser bulk resection  inflam-mation  prognosis

中文摘要:

      目的 探究经尿道钬激光整块切除术(HoLRBT)对高危老年非肌层浸润性膀胱癌(NMIBC)患者术后恢复、炎症反应及预后的影响.方法 回顾性选取2021年7月—2023年7月于青岛市胶州中心医院泌尿外科收治的120例高危NMIBC患者的临床资料,根据术式不同分为观察组(n=60)和对照组(n=60).观察组采用HoLRBT,对照组采用经尿道膀胱肿瘤等离子电切术(TURBt).比较2组围术期指标值、miR-119a、miR-200b水平、炎症指标[白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、高迁移率族蛋白1(HMGB1)、白细胞(WBC)、中性粒细胞]值、并发症发生率及复发率.结果 与对照组比较,观察组出血量更少,膀胱冲洗时间、尿管留置时间更短;术后3个月,2组miR-119a水平均低于同组术前,miR-200b水平高于同组术前;术后1 d,2组血清IL-6、TNF-α、CRP、HMGB1水平、WBC及中性粒细胞值均高于同组术前,且观察组低于对照组;观察组并发症发生率较对照组低;差异均有统计学意义(P＜0.05).2组复发率差异无统计学意义(P＞0.05).结论 HoLRBT治疗高危老年NMIBC疗效确切,有助于促进术后康复,创伤小,并发症少.

英文摘要:

      Objective To explore the effects of transurethral holmium laser bulk resection(HoLRBT)on postoperative recovery,inflammatory response and prognosis in high-risk patients with non-muscle invasive bladder cancer(NMIBC).Methods 120 high-risk NMIBC patients from Department of Urology of Jiaozhou Central Hospital from July 2021 to July 2023 were retrospectively selected.According to different surgical methods,they were divided into observation group(n=60)and control group(n=60).The observation group was treated with HoLRBT,while the control group was treated with transure-thral plasma resection of bladder tumor(TURBt).The perioperative index values,the levels of miR-119a,miR-200b,inflam-matory indicators[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),high mobility group protein 1(HMGB1),white blood cell(WBC),neutrophils],and incidence of complication and recurrence rates were com-pared between the two groups.Results Compared with the control group,the observation group had less bleeding,shorter bladder flushing time,and shorter urinary catheter retention time.Three months after the operation,the levels of miR-119a in both groups were lower than those in the same group before the operation,and the levels of miR-200b were higher than that in the same group before the operation.1 day after the operation,the levels of serum IL-6,TNF-α,CRP,HMGB1,WBC and neutrophil in both groups were higher than those in the same group before the operation,and the observation group was lower than the control group.The incidence of complications in the observation group was lower than that in the control group.The differences were all statistically significant(P＜0.05).There was no statistically significant difference in the recurrence rate between the two groups(P＞0.05).Conclusion HoLRBT has a definite therapeutic effect on high-risk elderly NMIBC pa-tients.It helps promote postoperative recovery with less trauma and fewer complications.