前列腺动脉栓塞术治疗良性前列腺增生临床效果及手术入路探讨  

Clinical efficacy of prostate artery embolization for benign prostatic hyperplasia and exploration of the optimal operative approach

作　　者：张淮[1] 赵卫[1] 胡继红[1] 姜永能[1] 罗罡[1] 潘文秋 ZHANG Huai;ZHAO Wei;HU Jihong;JIANG Yongneng;LUO Gang;PAN Wenqiu(Department of Medical Imaging,First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650032,China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,650032

出　　处：《介入放射学杂志》2022年第5期451-454,共4页Journal of Interventional Radiology

摘　　要：目的评价前列腺动脉栓塞术(PAE)治疗良性前列腺增生症(BPH)效果,探讨经肱动脉入路行PAE术的可行性和安全性。方法采用PAE术治疗11例BPH患者。术后随访36个月以上,观察比较手术前后国际前列腺症状评分(IPSS)、生活质量(QOL)评分、前列腺容积(PV)、最大尿流率(Qmax)、残余尿(RU)水平变化。观察其中3例肱动脉入路行PAE术患者手术成功率及相关并发症。结果PAE术远期临床成功8/10例。术后36、48、60个月分别有10例、10例、7例获随访,各时点患者IPSS、QOL评分、PV、Qmax、RU与术前比较,差异均有统计学意义(P<0.05),各时点两两比较,差异均无统计学意义(P>0.05)。3例肱动脉入路患者均完成双侧前列腺动脉栓塞,术后症状明显改善2例,缓解1例,未见手术相关并发症发生。结论PAE治疗BPH远期效果确切。肱动脉入路有助于栓塞双侧前列腺动脉,值得临床探索和应用。Objective To evaluate the efficacy of prostate artery embolization(PAE)in the treatment of benign prostatic hyperplasia(BPH),and to explore the feasibility and safety of PAE via brachial artery approach.Methods A total of 11 BPH patients received PAE treatment.The patients were followed up for more than 36 months.The postoperative international prostate symptom score(IPSS),quality of life(QOL)score,prostate volume(PV),maximum urinary flow rate(Qmax)and residual urine(RU)were compared with their preoperative data.The technical success rate and procedure-related complications in 3 patients who received PAE via brachial artery approach were recorded.Results The long-term clinical success rate of PAE was 8/10).Postoperative 36-,48-,and 60-month follow-up was accomplished in 10,10,and 7 patients respectively.The IPSS,QOL score,PV,Qmax and RU measured at each of the above mentioned follow-up time points,were significantly different from their preoperative ones(P<0.05),while no statistically significant differences in IPSS,QOL score,PV,Qmax and RU measured at the same time point existed between the routine approach group and brachial artery approach group(P>0.05).Bilateral PAE was accomplished in all the three patients who received PAE via brachial artery approach,and after PAE obvious improvement of symptoms was seen in 2 patients and relieve of symptoms was seen in one patient.No surgery-related complications occurred.Conclusion For the treatment of BPH,PAE has reliable long-term efficacy.Brachial artery approach is helpful for conducting bilateral PAE,therefore,it is worthy of clinical exploration and application.

关 键 词：良性前列腺增生症 前列腺动脉栓塞术 介入放射学 肱动脉入路 

分 类 号：R699.8[医药卫生—泌尿科学]