微创经尿道前列腺等离子电切术联合内分泌治疗高龄晚期前列腺癌合并尿潴留

发布时间：2019-04-02 18:06

【摘要】：目的探讨微创经尿道前列腺等离子电切术联合手术去势或药物去势治疗高龄晚期前列腺癌合并尿潴留的疗效和安全性。方法 2010年8月~2015年8月采用微创经尿道前列腺等离子电切术联合手术去势或药物去势治疗合并尿潴留晚期前列腺癌38例,观察术前后国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量评分(quality of life,QOL)、最大尿流率(Qmax)、血清前列腺特异性抗原(prostate specific antigen,PSA)变化和术后并发症。结果手术时间10~30 min,(18.9±5.7)min,术中和术后无输血,无前列腺电切综合征发生,拔除导尿管后均能自行排尿。术前IPSS中位数31分(30~35分),明显高于术后14分(10~21分)(Z=-7.548,P=0.000);术前QOL中位数6分(5~6分),明显高于术后1分(0~2分)(Z=-7.793,P=0.000);术前Qmax中位数2.3 ml/s(0~10.9 ml/s),明显低于术后15.8 ml/s(6.2~22.3ml/s)(Z=-7.154,P=0.000);术前PSA中位数50μg/L(8.5~500μg/L),明显高于术后PSA 0.2μg/L(0.01~9.3μg/L)(Z=-7.740,P=0.000)。结论微创经尿道前列腺等离子电切术联合手术去势或药物去势治疗合并尿潴留晚期前列腺癌安全、有效,可明显提高合并尿潴留晚期前列腺癌患者的生活质量。
[Abstract]:Objective to evaluate the efficacy and safety of minimally invasive transurethral prostatectomy combined with castration or drug castration in the treatment of advanced prostate cancer with urinary retention. Methods from August 2010 to August 2015, 38 cases of advanced prostate cancer with urinary retention were treated with minimally invasive transurethral plasma resection of prostate combined with castration or drug castration. International prostate symptom score (international prostate symptom score,IPSS) was observed before and after operation. Quality of life score (quality of life,QOL), maximum urinary flow rate (Qmax), serum prostate specific antigen (prostate specific antigen,PSA) changes and postoperative complications. Results there was no blood transfusion and no prostatectomy syndrome in the operation time of 10 min, 30 min, (18.9 卤5.7) min,. All patients were able to urinate themselves after removing the catheter. The mean preoperative IPSS score was 31 (30-35), which was significantly higher than that of 14 (10-21) (Z = 7.548, P < 0.000), and the mean preoperative QOL was 6 (5-6), which was significantly higher than that of 1 (0-2) (Z = 7.793, P < 0.000). The median Qmax 2.3ml/s (0 / 10.9 ml/s) before operation was significantly lower than that of 15.8 ml/s (6.2~22.3ml/s) after operation (Z = 7.154, P = 0.000). The median of preoperative PSA was 50 渭 g / L (8.5 ~ 500 渭 g / L), which was significantly higher than that of PSA 0.2 渭 g / L (0.01 ~ 9.3 渭 g / L) (Z / L) (7.740, P < 0.000). Conclusion minimally invasive transurethral prostatectomy combined with castration or drug castration is safe and effective in the treatment of advanced prostate cancer with urinary retention and can significantly improve the quality of life of patients with advanced prostate cancer with urinary retention.
【作者单位】：上海浦南医院泌尿外科;上海邮电医院泌尿外科;上海交通大学附属瑞金医院泌尿外科;
【基金】：上海浦东新区卫生系统重点学科建设资助(项目编号:PWZX 2014-19) 上海浦东新区科技发展基金创新资助(项目编号:PKJ 2013-y33)
【分类号】：R737.25

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