比较经尿道膀胱肿瘤电切（TURBT）术后联合静脉化疗与根治性膀胱切除术治疗肌层浸润性膀胱癌临床疗效。

回顾性分析2011年1月至2014年8月我院泌尿外科收治的96例T2期肌层浸润性膀胱癌（MIBC）患者的临床资料，根据治疗方法不同，将行TURBT联合静脉化疗的55例患者设为观察组，行根治性膀胱切除术的41例患者设为对照组。比较两组围手术期指标、并发症发生率及预后情况。

观察组患者手术时间为（65.3±12.5） min，术中出血量为（68.6±11.2） ml，肠道恢复时间为（1.4±0.3）d；对照组患者手术时间为（172.3±27.4） min、术中出血量为（398.3±96.3）ml、肠道恢复时间为（4.3±0.6）d。观察组的手术时间、肠道功能恢复时间、术中出血量均优于对照组，差异有统计学意义（P<0.05）。观察组术后并发症发生率为16.3%，明显较对照组（52.2%）少；远期并发症中，观察组在反复泌尿感染的发生率为3.6%，明显较对照组（26.8%）少，以上差异均有统计学意义（P<0.05），两组在肾积水的发生率差异无统计学意义（P>0.05）；随访期间，两组患者复发率，1年、3年及5年总生存率及肿瘤特异性生存率比较中，差异无统计学意义（P>0.05）。

选择合适的MIBC患者的前提下，TURBT术后联合静脉化疗的预后较根治性膀胱切除术相当，且其手术创伤更小，术后生存质量亦更优。

To compare the clinical efficacy of transurethral resection of the bladder tumor(TURBT) combined with intravenous chemotherapy and radical cystectomy in the treatment of muscle invasive bladder cancer(MIBC).

A retrospective analysis was made of the clinical data of 96 patients with stage T2 MIBC admitted to the urology department of our hospital from January 2011 to August 2014. According to the different treatment methods, 55 patients with TURBT combined with intravenous chemotherapy were selected as observation group and 41 patients with radical cystectomy (RC) as control group. The perioperative indexes, incidence of complications and prognosis were compared between the two groups.

In the observation group, the operative time was (65.3±12.5) min, the intraoperative blood loss was (68.6±11.2) ml, and the intestinal recovery time was (1.4±0.3) d. In the control group, the operative time was (172.3±27.4) min, the intraoperative blood loss was (398.3±96.3) ml, and the intestinal recovery time was (4.3±0.6) d. The operative time, intestinal function recovery time and intraoperative blood loss of the observation group were all better than those of the control group, with statistically significant differences (P<0.05). The incidence of postoperative complications in the observation group was 16.3%, significantly lower than that in the control group (52.2%). Among the long-term complications, the incidence of recurrent urinary infection in the observation group was 3.6%, significantly lower than that in the control group (26.8%), and the above differences were statistically significant (P<0.05).There was no significant difference in the incidence of hydronephrosis between the two groups (P>0.05). During the follow-up period, there was no significant difference in the recurrence rate, 1-year, 3-year and 5-year overall survival rate and tumor-specific survival rate between the two groups (P>0.05).

The prognosis of TURBT combined with intravenous chemotherapy is similar to that of RC, and the surgical trauma is smaller and the quality of life is better after TURBT combined with intravenous chemotherapy.