中晚期前列腺癌致膀胱出口梗阻的治疗(附38例报告)  

The treatment of bladder outlet obstruction induced by advanced prostate carcinomas(38 cases)

作　　者：熊林[1] 邹茜[1] 余书勇[1] 沈宏峰[1] 李威[1] 何耿[1] 康璇[1] 

机构地区：[1]解放军第187医院泌尿外科,海南海口571159

出　　处：《中国现代医学杂志》2012年第7期87-90,共4页China Journal of Modern Medicine

摘　　要：目的探讨经尿道超脉冲等离子体双极电切（bipolar plasm akinetic superpulse transurethral resection of the prostate,PKSP＋TURP）联合双侧睾丸切除术治疗中晚期前列腺癌（prostate carcinom as,PCa）所致的膀胱出口梗阻（bladder outlet obstruction,BOO）的临床疗效。方法回顾分析该院2006年1月~2010年10月接受PKSP＋TURP联合双侧睾丸切除术治疗中晚期PCa所致的BOO患者临床资料。结果 38例手术顺利并随访3~60个月,术后3个月IPSS由（25.8±6.5）分下降至（15.4±3.9）分（t=5.706,P=0.000）,QOL由（4.6±0.7）分下降至（2.8±0.8）分（t=6.387,P=0.000）,Qmax由（7.6±2.5）mL/s上升至（15.5±4.1）mL/s（t=-22.417,P=0.000）,RU由（79.8±29.6）mL减少至（34.1±9.9）mL（t=6.801,P=0.000）。5例于术后15～56个月再次出现急性尿储留行耻骨上膀胱造瘘术,8例因肿瘤广泛转移分别于术后20～58个月死亡,5例于术后13～53个月死于其他内科疾病。结论 PKSP＋TURP联合双侧睾丸切除术可作为治疗中晚期PCa的姑息性治疗措施,并能迅速、安全、有效的解除中晚期PCa所导致的BOO。【Objective】 To evaluate the clinical efficacy of the intraluminal enucleation and bipolar plasmakinetic superpulse transurethral resection of the prostate in treatment of bladder outlet obstruction induced by advanced prostate carcinomas.【Methods】 38 patients of bladder outlet obstruction induced by advanced prostate carcinomas underwent PKSP＋TURP and intraluminal enucleation from January 2006 to October 2010 were reviewed.【Results】 38 patients were treated successfully and followed up from 3 to 60 months.After 3 months of operation,the IPSS decreased from（25.8±6.5） to（15.4±3.9）,the QOL decreased from（4.6±0.7） to（2.8±0.8）,the Qmax increased from（7.6±2.5） mL/s to（15.5±4.1） mL/s,the RU volume decreased from（15.5±4.1） mL to（34.1±9.9）mL.【Conclusions】 Bipolar plasmakinetic superpulse transurethral resection of the prostate and intraluminal enucleation in treatment of bladder outlet obstruction induced by advanced prostate carcinomas has advantages of high safety,less complication and satisfactory efficacy.

关 键 词：前列腺癌 超脉冲等离子体双极 双侧睾丸切除术 膀胱出口梗阻 

分 类 号：R737.25[医药卫生—肿瘤]