前列腺动脉栓塞术后阴茎缺血并发症的原因分析与处理对策  

Cause and management strategy of penile ischemic complication after prostate artery embolization in benign prostatic hyperplasia

作　　者：权晖 陈述[1] 李金保[1] 熊玮[1] 孙培勤[1] 胡泊 QUAN Hui;CHEN Shu;LI Jinbao;XIONG Wei;SUN Peiqin;HU Bo(Department of Interventional Vascular Surgery,Baoji Central Hospital,Baoji 721008,China;Department of Radiology,Shaanxi Traditional Chinese Medicine Hospital,Xi'an 710003,China)

机构地区：[1]宝鸡市中心医院介入血管外科,陕西宝鸡721008 [2]陕西省中医医院放射科,陕西西安710003

出　　处：《实用放射学杂志》2019年第12期1993-1995,2001,共4页Journal of Practical Radiology

基　　金：宝鸡市卫计局科研基金项目(2016-30)。

摘　　要：目的分析前列腺动脉栓塞术(PAE)治疗良性前列腺增生(BPH)患者术后合并阴茎缺血的原因,探讨PAE治疗BPH的手术技巧及安全性。方法采用PAE治疗47例BPH患者,术中根据前列腺动脉造影显示的结果采用不同策略进行栓塞治疗。结果47例患者术中造影发现,6例阴部内动脉末端发出阴茎动脉显影,3例阴部内动脉末端分支与对侧膀胱下动脉交通。术中采用吸收性明胶海绵颗粒、聚乙烯醇(PVA)颗粒交叉栓塞,术后1个月、3个月、6个月、12个月影像资料和临床症状均有明显改善,除4例阴茎缺血外无严重并发症出现。结论根据前列腺动脉的显影特点采用合适的栓塞方法,在保证其治疗BPH的有效性的同时,可极大地提高该手术的安全性。Objective To analyze the causes o£postoperative penile ischemia in patients with benign prostatic hyperplasia(BPH)treated with prostate artery embolization(PAE),and explore the surgical technique and safety of PAE for BPH.Methods 47 patients with BPH were treated with PAE.Different embolization strategies were adopted according to the results of prostate angiography.Results Intraoperative angiography was performed in 47 patients.6 cases with penile artery developed at the end of the pudendal artery,and 3 cases with the end of the pudendal artery crosslinked with the contralateral lower bladder artery.Intraoperative gelatin sponge particles and PVA particles were cross-embolized.The imaging fingdingsand clinical symptoms were significantly improved 1 month,3 months,6 months and 12 months after surgery.No serious complications occurred except for the 4 cases of penile ischemia.Conclusion Appropriate embolization method according to the microanatomy of the prostate artery can significantly improve the safety and effectiveness of the treatment of BPH.

关 键 词：良性前列腺增生 前列腺动脉栓塞术 阴茎动脉显微解剖 

分 类 号：R697.33[医药卫生—泌尿科学] R815[医药卫生—外科学]