高危良性前列腺增生介入治疗初步探讨  

Tentative study on interventional therapy for high risk benign prostatic hyperplasia

作　　者：刘祥鹏[1] 武立新[1] 张万高[2] 胡茂能[1] 含笑[1] 王国亮[1] 陈冬[1] 李龙[1] 申广 LIU Xiang-peng;WU Li-xin;ZHANG Wan-gao(Hefei Third Clinical College of Anhui Medical University(Hefei Third People's Hospital,Interventional),Hefei 230022,Anhui;The First Affiliated Hospital of Anhui University of traditional Chinese Medicine,Hefei 230031,Anhui)

机构地区：[1]安徽医科大学合肥第三临床学院(合肥市第三人民医院),安徽合肥230022 [2]安徽中医药大学第一附属医院介入科,安徽合肥230031

出　　处：《安徽医专学报》2022年第2期25-26,29,共3页Journal of Anhui Medical College

基　　金：合肥市卫生计生应用医学研究项目(编号:hwk2016yb006)。

摘　　要：目的:探讨前列腺动脉栓塞术治疗高危良性前列腺增生患者的安全性及有效性。方法:回顾性分析9例行前列腺动脉栓塞术高危良性前列腺增生患者临床资料,比较术后1周、1个月和6个月最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)和前列腺体积变化。结果:9例患者中8例行双侧前列腺栓塞术,术后6个月最大尿流率(Qmax)由术前(5.9±4.9)mL/s上升为(17.1±1.1)mL/s(P<0.05);国际前列腺症状评分(IPSS)由术前(26.8±3.2)分降至(5.6±1.5)分(P<0.05);生活质量评分(QOL)由术前(5.1±8.3)分降至术后(2.3±4.6)分(P<0.05);前列腺体积由(57.0±7.1)mL降至(34.4±4.1)mL(P<0.05)。另外1例患者因髂内动脉粥样硬化介入时出现夹层,仅行单侧栓塞,术后仍尿潴留,保留导尿3个月拔除导尿管仍尿潴留,然后行膀胱造瘘术。结论:高危良性前列腺增生患者行PAE治疗安全性高,行双侧栓塞治疗疗效优于单侧栓塞,术前对患者作好评估以及取得患者及其家属理解和同意,PAE可作为高危前列腺增生患者的一种治疗方式。Objective:To investigate the safety and efficacy of prostate artery embolization in the treatment of high-risk benign prostatic hyperplasia.Methods:The clinical data of 9 patients with high-risk benign prostatic hyperplasia who underwent prostatic arterial embolization were retrospectively analyzed.The changes of maximum urine flow rate(Qmax),international prostate symptom score(IPSS),quality of life score(QOL)and prostate volume at 1 week,1 month and 6 months after operation were compared.Results:8 of the 9 patients successfully underwent bilateral prostate embolization.The maximum urinary flow rate(Qmax)increased from(5.9±4.9)mL/s to(17.1±1.1)mL/s(P<0.05);The International Prostate Symptom Score(IPSS)decreased from(26.8±3.2)to(5.6±1.5)(P<0.05);QOL decreased from(5.1±8.3)before operation to(2.3±4.6)after operation(P<0.05);The volume of prostate decreased from(57.0±7.1)mL to(34.4±4.1)mL(P<0.05).The remaining 1 patient suffered from dissection during internal iliac atherosclerosis intervention,so only unilateral embolization was performed,and postoperative urinary retention was still maintained.After 3 months of catheterization,the catheter was removed and the urinary retention remained and then cystostomy was performed.Conclusion:PAE is safe to be used in patients with high-risk benign prostatic hyperplasia,and the curative effect of bilateral embolization is better than unilateral embolization.Preoperative evaluation of patients and the understanding and consent of patients and their families can be used as a treatment for patients with high-risk benign prostatic hyperplasia.

关 键 词：良性前列腺增生 前列腺动脉 介入栓塞术 

分 类 号：R697.3[医药卫生—泌尿科学]