经尿道等离子电切术治疗表浅性膀胱癌的并发症及防治体会.docVIP

经尿道等离子电切术治疗表浅性膀胱癌的并发症及防治体会 　　[摘要] 目的 探讨经尿道等离子体双极电切术（PKRBT）治疗表浅性膀胱癌的疗效和安全性。方法 采用PKRBT治疗表浅性膀胱癌78例，观察疗效及并发症；术后24 h内单次膀胱灌注，每3个月膀胱镜检查1次。结果 78例患者均成功完成手术，手术时间为20～70 min，平均40 min。无一例发生电切综合征，46例侧壁肿瘤电切时，11例发生闭孔神经反射，3例轻度膀胱穿孔，71例患者术后随访12～48个月，12例复发，1年复发率为14.1%（10/71）。结论 PKRBT治疗表浅性膀胱癌安全、有效，闭孔神经反射是常见并发症之一。 　　[关键词] 表浅性膀胱癌；经尿道电切术；等离子体双极电切术；并发症 　　[中图分类号] R737 [文献标识码] A [文章编号] 1674-4721（2013）07（a）-0018-03 　　Complication prevention and cure in transurethral resection of superficial bladder tumor with plasmakinetic resection 　　HUANG Yan-song1 YANG Jing-qiu2 CHEN Shao-kai1 　　1.Department of Urology， Dafeng Hospital of Chaoyang District in Shantou City of Guangdong Provicne， Shantou 515154， China； 2.Department of Urology， the Second Affiliated Hospital of Shantou University Medical College in Guangdong Provicne， Shantou 515041， China 　　[Abstract] Objective To assess the efficacy and safety of transurethral resection of superficial bladder tumor treated with plasmakinetic resection of the bladder tumor（PKRBT）. Methods 78 patients with superficial bladder tumor were treated by PKRBT. The efficacy and complications were observed and recorded. Bladder perfusion was given once in 24 h after PKRBT. Cystoscopy was given every 3 months. Results All surgery of 78 patients were successful. The operative duration of the procedure was 20 to 70 min （average of 40 min）. No transurethral resection syndrome（TURS） was found. In 46 cases with tumor located at the lateral of bladder，11 cases（23.9%） occurred obturator nerve reflex and 3 cases occurred slight bladder perforation. 71 patients were followed up for 12 to 48 months postoperatively. 12 patients relapsed and the recurrence rate was 14.1%（10/71）. Conclusion Transurethral resection of superficial bladder tumor with PKRBT is effective and safe. The obturator nerve reflex is one of the common complications of PKRBT. 　　[Key words] Superficial bladder tumor； Transurethral resection； Plasmakinetic resection； Complications 　　膀胱癌是我国泌尿外科临床最常见的恶