经导管动脉栓塞术治疗前列腺源性顽固性血尿的疗效观察  

Role of transcatheter arterial embolization in the management of refractory hematuria of prostatic origin

作　　者：张金龙 段峰[1] 袁凯[1] 张秀军 王全玉 李志强[4] 潘杰[5] 李晓光[6] 王茂强[1] Zhang Jinlong;Duan Feng;Yuan Kai;Zhang Xiujun;Wang Quanyu;Li Zhiqiang;Pan Jie;Li Xiaoguang;Wang Maoqiang(Department of lnterventional Radiology,Chinese PLA General Hospital,Beifing 100853,China;Department of Interventional,Tianjin Hospital of ITCWM Nankai Hospital,Tianjin 300100,China;Department of Endoscopic Interventional Surgery,Huabei Petroleum General Hospital,Renqiu 062552,China;Department of Interventional,the Affiliated Hospital of Hebei University,Baoding 071000,China;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Minimally Invasive Tumor Therapies Center,Beijing Hospital, Beijing 100005,China)

机构地区：[1]解放军总医院介入放射科,北京100853 [2]天津市中西医结合医院南开医院介入血管科,300100 [3]华北石油管理局总医院内镜介入外科,任丘062552 [4]河北大学附属医院介入血管科,保定071000 [5]中国医学科学院北京协和医学院北京协和医院放射科,100730 [6]北京医院肿瘤微创治疗中心,100005

出　　处：《中华放射学杂志》2019年第2期121-126,共6页Chinese Journal of Radiology

基　　金：国家自然科学基金(81471769);中央保健科研课题(W2013BJ09);军队“十二五”重点项目(BWS11J028);北京市科技新星课题(Z141107001814099).

摘　　要：目的评估经导管动脉栓塞术(TAE)治疗前列腺源性顽固性血尿(RHPO)患者的安全性及疗效。方法回顾性分析2011年2月至2017年1月,国内6家大型教学医院收治的经TAE治疗的31例RHPO患者的病例资料。纳入标准:影像及临床资料完整的RHPO患者;排除标准:临床资料不完整、不能评估止血效果,存在TAE相关的禁忌证。入选患者年龄58~84岁,平均(75.0±7.5)岁。RHPO原因:良性前列腺增生9例、前列腺癌12例、经尿道前列腺切除术后4例、开放式前列腺切除术后2例、前列腺肉瘤4例。根据患者病因及造影情况,行超选择性动脉栓塞术、非超选择性动脉栓塞术或动脉内灌注化疗。观察并记录血管造影表现、技术成功率、临床成功率、并发症发生率情况进行观察。结果血管造影发现活动性出血6例(19.4%),动脉瘤4例(12.9%),异常新生血管27例(87.1%)。31例患者,成功进行37次TAE,近期止血成功率为90.3%(28/31)。轻度并发症发生率为38.7%(13/31),未出现TAE相关严重并发症。结论TAE是治疗前列腺源性顽固性血尿安全、有效的方法。Objective To evaluate the safety and efficacy of transcatheter arterial embolization (TAE) in the management of refractory hematuria of prostatic origin (RHPO). Methods This retrospective study from 6 hospitals in china consisted of 31 patients (mean age 75.0±7.5 years, range 58 to 84 years) who underent transcatheter arterial embolization (TAE) for RHPO between February 2011 and January 2017. Patients with RHPO who had complete imaging and clinical data were enrolled. Patients with incomplete clinical data, inability to assess hemostasis, and contraindications to TAE were excluded. The cause of RHPO was benign prostatic hyperplasia (BPH) in nine patients, prostate cancer in twelve, transurethral resection of prostate in four, open prostatectomy in two and prostatic sarcoma in four. Superselective arterial embolization, non-superselective arterial embolization or intra-arterial infusion chemotherapy was performed according to the etiology and angiography. Angiographic findings, technical success rate, clinical success rate, complications were recorded. Results Of the 31 patients, 6 patients (19.4%) were with active bleeding, 4 (12.9%) with aneurysm and 27 (87.1%) with abnormal neovascularization on the angiogram. The 31 patients underwent a totle of 37 TAE, the technical success rate was 100.0%(37/37) and the recent hemostasis success rate was 90.3% (28/31). The incidence of mild complications was 38.7%(13/31), there was no serious complication associated with TAE. Conclusion TAE is a safe and effective method for the treatment of refractory hematuria of prostatic origin.

关 键 词：血尿 前列腺增生 前列腺肿瘤 放射学 介入性 

分 类 号：R699[医药卫生—泌尿科学]