前列腺动脉栓塞术治疗重度前列腺增生所致尿潴留的临床应用  

A clinical application of prostatic arterial embolization for the treatment of urinary retention as a result of large benign prostatic hyperplasia

作　　者：袁冰 张金龙 王茂强[1] 袁凯[1] 姜文浩 李志强[3] 孙成建[4] 张秀军[5] Yuan Bing;Zhang Jinlong;Wang Maoqiang(Department of Interventional Radiology,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院介入放射科,北京100853 [2]北京市第二医院 [3]河北大学附属医院介入血管科 [4]青岛大学附属医院介入医学科 [5]南开大学附属南开医院介入血管科

出　　处：《中华保健医学杂志》2018年第5期364-367,共4页Chinese Journal of Health Care and Medicine

基　　金：国家自然科学基金(81471769);中央保健科研课题(2013BJ09);军队十二五重点课题(BWS11J028);解放军总医院苗圃基金课题(16KMM04)

摘　　要：目的探讨超选择性前列腺动脉栓塞术(PAE)治疗重度良性前列腺增生(BPH)所致尿潴留的安全性及有效性。方法回顾性分析2015年1月～2017年12月解放军总医院介入放射科收治的12例因BPH导致的尿潴留、留置导尿管或膀胱造瘘管(≥1个月)的患者资料,年龄80～91岁,平均(82.6±3.4)岁,均不适宜外科治疗。全部患者采用1.9～2.7 Fr微型导管、50～100μm的聚乙烯醇颗粒进行栓塞,临床成功定义为术后拔除导尿管或膀胱造瘘管并恢复自主排尿。术后3、6、12个月评估国际前列腺症状评分(IPSS)、生活质量评分(Qo L)、前列腺体积(PV)、前列腺特异抗原(PSA)。结果 PAE术后均未发生严重并发症,9例患者术后2周内成功拔除导尿管并恢复自主排尿,2例于术后3～4周拔除,临床成功率为91.7%(11/12)。与术前相比,PAE术后3、6、12个月的IPSS、Qo L、PV、PSA差异均有统计学意义(P <0.05)。结论 PAE治疗重度BPH所致的尿潴留安全性高、疗效确切。ObJective To evaluate the effectiveness and safety of prostatic arterial embollzation as a primary treatment for urinary retention as a result of large benign prostatic hyperplasia. Methods This study enrolled 12 catheter-dependent aged patients with urinary retention as a result of large benign prostatic hyperplasia from January 2015 to December 2017,these patients were relatively elderly,with a mean age of 82.6 years ± 3.4（range,80-91years）,can not tolerate surgery. Prostatic arterial embolization was carried out using 1.9-2.7 Fr microcatheter and 50-100 μm particles. Clinical follow up was carried out using the International Prostate Symptom Score,quality of life,prostatic volume,and prostate-specific antigen at 3,6,12 months. Clinical successful were defined as remove the catheter. Results There were no severe complications occur. A clinical successful was achieved in 91.7% （11/12）. There was an significant improvement in terms of International Prostate Symptom Score,quality of life, prostatic volume, and prostate-specific antigen （P 〈 0.05）. Conclusion Prostatic arterial embolization seems to be a safe and effective treatment method for urinary retention as a result of BPH.

关 键 词：良性前列腺增生 尿潴留 栓塞术 介入放射学 

分 类 号：R699[医药卫生—泌尿科学]