姑息性电切对晚期前列腺癌下尿路症状改善的应用评价  

Evaluation of palliative transurethral resection of prostate for advanced prostate cancer with lower urinarytract symptoms

作　　者：杨立[1] 郑宝寿[1] 萧芝松[1] 肖玉坤[1] 文贵成[1] 

机构地区：[1]大理学院临床医学院附属医院泌尿外科,大理671000

出　　处：《中国男科学杂志》2013年第6期42-45,共4页Chinese Journal of Andrology

摘　　要：目的 探讨姑息性经尿道前列腺电切术（pTURP）在晚期前列腺癌伴有下尿路症状（LUTS）患者中的应用。方法对45例伴显著LUTS的晚期前列腺患者临床资料进行回顾性分析，所有患者均行最大限度雄激素阻断（手术去势＋抗雄激素药物），28例同时行pTURP，17例间断留置尿管而未行pTURP。比较术后不同时间段患者PSA、IPSS评分，评估手术并发症及不利事件，分析影响TURP预后相关因素。结果pTURP患者短期内LUTS可获明显改善，但可能发生如尿路感染、血尿、排尿困难及肿瘤复发等并发症，远期有转为激素非依赖型肿瘤、再次留置尿管或病情进展、远处转移等不良事件出现。结论pTURP作为一种姑息性辅助治疗手段，可在短期内有效改善下尿路症状。而激素依赖、尿潴留、反复血尿以及前列腺中叶凸向膀胱是pTURP治疗后症状改善良好的相关因素。Objective To investigate the application of palliative transurethral resection of the prostate （pTURP） in the treatment of advanced prostate cancer with lower urinary tract symptoms （LUTS）. Methods Clinical data of 43 cases of advanced prostate cancer with LUTS were analysised retrospectively. All the patients were treated with bilateral orchidectomy and anti-androgenic treatment. The pTURP were used in 28 cases and intermittent catheterization in 17 cases without pTURP. PSA level and IPSS score at different times after operation were comparatively analyzed, the complications and the adverse event, and the the prognostic factors of using pTURP were assessed. Results The LUTS of patients who underwent pTURP could be improved in short-term, but these complications such as urinary tract infection, hematuresis, dysuria and tumor recurrence may occur. The adverse events as transforming to androgen-independent tumors, once again the indwelling catheter, or the progress of the disease with distant metastasis may occur in long term. Conclusion In the treatment of advanced hormone-refractory prostate cancer with LUTS, pTURP as a palliative adjuvant therapy method can improve effectively the patients＇ LUTS in the shor-term. Hormone dependent, urine retention, recurrent hematuria and the median lobe of the prostate protruding into the bladder are the excellent prognosis related factors for pTURP.

关 键 词：前列腺肿瘤 下尿路症状 经尿道前列腺切除术 

分 类 号：R737.25[医药卫生—肿瘤]