TURP联合雄激素阻断治疗晚期前列腺癌伴膀胱出口梗阻疗效观察  

Effect Observation of TURP Combined with Androgen Blockade for Advanced Prostate Cancer with Bladder Outlet Obstruction

作　　者：汪志顺[1] 刘修恒[1] 陈胜[1] 肖腾飞[1] 匡幼林[1] 

机构地区：[1]武汉大学人民医院泌尿科,湖北省武汉市430060

出　　处：《职业与健康》2011年第21期2508-2510,共3页Occupation and Health

摘　　要：目的探讨经尿道前列腺电切(TURP)联合雄激素阻断治疗晚期前列腺癌伴膀胱出口梗阻的临床疗效。方法回顾性分析23例应用TURP联合雄激素阻断治疗晚期前列腺癌伴出口梗阻患者的临床资料,观察患者住院时间、手术时间、留置尿管时间,及手术前后前列腺体积、生活质量评分(QOL)、国际前列腺症状评分(IPSS)、前列腺特异性抗原(PSA)、最大尿流速度(Qmax)、残余尿量(RU)的变化。结果 23例患者手术均成功,1例术后输血400 ml,无前列腺电切综合征现象,住院天数(9.0±3.2)d,手术时间45～120 min,术后留置导尿管时间5～7 d。术前前列腺体积、QOL、IPSS、PSA、Qmax、RU分别为(87.53±18.46)cm3、(3.54±1.16)分、(18.96±3.83)分、(76.32±20.47)μg/L、(9.08±2.76)ml/s、(142.53±34.66)ml,术后1个月前列腺体积(46.52±13.43)cm3、QOL(2.15±1.30)分、IPSS(12.78±3.34)分、PSA(1.82±0.63)μg/L、Qmax(19.20±3.98)ml/s、RU(29.86±16.33)ml,手术前后上述指标比较,差异均有统计学意义(均P<0.01),术后第3个月PSA(0.66±0.21)μg/L(P<0.01)。结论 TURP联合雄激素阻断治疗晚期前列腺癌伴膀胱出口梗阻安全、有效,近期疗效确切,能明显缓解患者尿路梗阻症状,提高患者生活质量,但远期疗效有待进一步研究。[Objective]To evaluate the clinical efficacy of transurethral resection of prostate（TURP） with androgen blockade for advanced prostate cancer with bladder outlet obstruction. [Methods]Retrospective analysis was performed on 23 patients with advanced prostate cancer and bladder outlet obstruction who underwent the TURP treatment with androgen blockade.Length of stay,operation time,indwelling catheter time,prostate volume before and after operation,quality of life（QOL）,international prostate symptom（IPSS）,prostate specific antigen（PSA）,maximum urine flow（Qmax）,and residual urine（RU） were recorded. [Results]All operations were performed successfully,only one patient received 400ml blood transfusion after operation and none of them had TURP syndrome,length of stay was（9±3.2）d,the operative time was 45~120 min,indwelling catheter time was 5~7 d.Preoperative prostate volume,QOL,IPSS,PSA,Qmax and RU were（87.53±18.46）cm3,（3.54±1.16）points,（18.96±3.83）points,（76.32±20.47）μg/L,（9.08±2.76）ml/s,（142.53±34.66）ml,after one month,prostate volume（46.52±13.43）cm3,QOL（2.15±1.30）points,IPSS（12.78±3.34）points,PSA（1.82± 0.63）μg/L,Qmax（19.20±3.98）ml/s,RU（29.86±16.33）ml,respectively,all indicators were significant before and after operation（all P0.01）;after 3 months PSA was（0.66±0.21）μg/L（P0.01）. [Conclusion]TURP combined with androgen blockade for advanced prostate cancer with bladder outlet obstruction is safe and effective,with good short-term curative effect,can alleviate the urinary tract obstruction symptoms and improve the quality life of patients.However,the long-term effect deserves further research.

关 键 词：前列腺癌 经尿道前列腺电切 雄激素阻断 膀胱出口梗阻 

分 类 号：R737.25[医药卫生—肿瘤]