经尿道等离子前列腺电切术治疗晚期前列腺癌膀胱出口梗阻37例  

Transurethral Plasmakinetic Prostatectomy for Treatment Bladder Outlet Obstruction Induced by Advanced Prostatic Cancer (Report of 37 Cases)

作　　者：颜汝平[1] 赵庆华[2] 王剑松[1] 左毅刚[1] 王伟[1] 柯昌兴[1] 詹辉[1] 丁明霞[1] 

机构地区：[1]昆明医学院第二附属医院泌尿外科云南省泌尿外科研究所,昆明650101 [2]昆明医学院第二附属医院妇科云南省泌尿外科研究所,昆明650101

出　　处：《中国中西医结合外科杂志》2010年第3期272-274,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨晚期前列腺癌膀胱出口梗阻的治疗方法。方法:经尿道等离子前列腺电切术姑息治疗37例患者,建立宽敞的通道,并且联合行睾丸切除去势和间歇内分泌治疗。结果:本组手术均获成功,无尿失禁和电切综合征等严重并发症发生,下尿路梗阻症状均明显改善或消失。术后2个月国际前列腺症状评分(IPSS)由术前的(21.2±3.5)下降至(9.1±1.8)(P<0.05),生活质量评分(QOL)由治疗前(4.6±1.2)降至(2.1±0.4)(P<0.05),最大尿流率由(8.1±2.8)mL/s上升为(18.9±2.1)mL/(sP<0.05)。结论:经尿道等离子前列腺电切术具有微创、恢复快和并发症少的优势,能有效改善晚期前列腺癌患者的膀胱出口梗阻症状和生存质量;联合睾丸切除去势和间歇内分泌治疗还可以抑制肿瘤生长、延长患者生存时间。Objective To explore the treatment of bladder outlet obstruction （BOO） induced by advanced prostatic cancer. Methods Thirty-seven patients with BOO induced by advanced prostatic cancer were treated palliatively by transurethral plasmakinetic prostatecdomy （TUPKP）. Spacious channel was established. Orchiectomy and intermittent hormonal therapy were used jointly. Results All cases were successful and no serious complications such as urinary incontinence or transurethral resection syndrome （TURS） happened. The symptoms of lower urinary tract obstruction were all significantly improved or disappeared. International prostate symptom scores （IPSS） decreased from 21.2±3.5 preoperatively to 9.1±1.8 postoperatively （P 0.05）. Quality of life scores （QOL） dropped from 4.6±1.2 to 2.1±0.4 （P 0.05）. Maximum flow rate （MFR） increased from （8.1±2.8 ） mL/s to （18.9±2.1） mL/s （P 0.05）. Conclusion TUPKP is dominated in microinvasion, quick recovery and less complications. The symptoms of BOO caused by advanced prostatic cancer and the survival quality can be improved effectively. The combined application of TUPKP, orchiectomy and intermittent hormonal therapy can inhibit tumor growth and prolong survival time.

关 键 词：前列腺癌 等离子电切术 膀胱出口梗阻 

分 类 号：R735.25[医药卫生—肿瘤]