中药白芨用于前列腺动脉栓塞治疗良性前列腺增生的临床研究  

Clinical study of prostatic arterial embolization jointly with Bletilla Striata for the treatment of benign prostatic hyperplasia

作　　者：周学鲁[1] 周上军[1] 占平[1] 叶淦 张继峰[1] 张剑锋[1] 胡灏[1] Zhou Xuelu;Zhou Shangjun;Zhan Ping;Ye Gang;Zhang Jifeng;Zhang Jianfeng;Hu Hao(The First Department of Surgery, Affiliated Dongguan Hospital, Guangzhou University of Chinese Medicine, Dongguan 523127, China)

机构地区：[1]广州中医药大学附属东莞中医院外一科,广东东莞523127

出　　处：《中华介入放射学电子杂志》2017年第2期89-93,共5页Chinese Journal of Interventional Radiology：electronic edition

基　　金：广东省东莞市社会科技发展项目(201450715000167)

摘　　要：目的:探讨中药白芨用于前列腺动脉栓塞治疗良性前列腺增生(BPH)的方法及疗效。方法:选取2013年6月—2016年12月我院收治的BPH患者30例,均是采用药物后治疗不佳且发生临床进展,进行前列腺动脉插管后,注入白芨粉粒和优维显混合液。记录患者术前和术后1、3、6和12个月的国际前列腺症状评分(IPSS)、生活质量评分(QOL)和国际勃起功能评分(IIEF),最大尿流率(Qmax)、剩余尿量(PRV)和前列腺体积(PV)。判定其临床疗效,并分析并发症产生的可能原因。结果:IPSS、QOL、PRV和PV逐步降低,PV平均缩小62.19%;Qmax逐步升高,差异均有统计学意义(P<0.05),但是栓塞前后的IIEF评分无明显变化(P>0.05)。1例患者出现少量血尿,2例发生会阴和大腿疼痛,1例出现会阴部皮肤坏死,经对症治疗后均明显好转。结论:白芨用于前列腺动脉栓塞治疗BPH安全有效、微创、并发症少,是临床上可行的新方法。Objective:To explore the efficacy of Bletilla Striata combined with prostatic artery embolization(PAE)in the treatment of benign prostatic hyperplasia(BPH)and determine its feasibility and safety.Methods:PAE with Bletilla Striata were performed in thirty patients with BPH who failed in medical treatment.International Prostate Symptom Score(IPSS),Quality of Life(QOL)and International Index of Erectile Function(IIEF)were recorded.Peak urinary flow(Qmax),postvoid residual volume(PRV)and prostate volume(PV)were also measured before and after PAE.The complications were retrospectively analyzed.Results:PAE was technically successful in twenty-nine patients.Follow-up time was12months.IPSS was decreased from26.69to6.14points,QOL was improved from4.76to1.22points(P<0.05),and IIEF decreased0.21points(from13.90to13.69),but there was no significant difference(P>0.05).Qmax increased13.03ml/s(from9.75to22.79ml),while PVR decreased from131.79ml to4.45ml(P<0.05).A mean prostate volume was reduced by62.19%(85.66to32.38ml)(P<0.05).There were three minor complications,one with mild hematuresis and two with pain in perineum regions.One patient had skin necrosis in the perineum region.Conclusions:PAE in treatment of BPH with Bletilla Striata is feasible,efficacious and safe.However,further studies are needed to assess its longer term result and potential morbidity.

关 键 词：良性前列腺增生 动脉栓塞 白芨 介入放射学 

分 类 号：R697.3[医药卫生—泌尿科学]