双侧复合性栓塞治疗前列腺源性顽固血尿疗效观察  

Efficacy of bilateral prostate artery embolization in the treatment of intractable prostatogenic hematuria

作　　者：张栋邦 胡森[1] 赵宝魁 多杰才让 方睿 ZHANG Dong-bang;HU Sen;ZHAO Bao-kui;DUO-JIE Cai-rang;FANG Rui(Department of Urology,Qinghai Red Cross Hospital,Qinghai 810000,China)

机构地区：[1]青海红十字医院泌尿外科,青海西宁810000

出　　处：《影像诊断与介入放射学》2022年第6期411-415,共5页Diagnostic Imaging & Interventional Radiology

基　　金：2022-2023年青海省卫健委指导性计划课题(2021-wjzdx-63)。

摘　　要：目的本研究旨在探讨复合性栓塞双侧前列腺动脉(PA)治疗高龄高危前列腺源性顽固性血尿(RHPO)的临床应用价值。方法选取2018年11月~2021年11月我院收治无法耐受外科手术高龄高危RHPO患者44例,观察组(n=22)行复合性双侧前列腺动脉栓塞术(PAE),对照组(n=22)应用药物及导尿管牵拉术止血,对比两组患者止血成功率、出血复发率、并发症发生等情况,评估复合性栓塞治疗RHPO的疗效。结果研究组技术成功率为95.45%(21/22),48 h内止血成功率为100%。相对于对照组,PAE组术后半年再出血率更低(4.54%比72.72%,P<0.01),深静脉血栓发生更低(0%比18.18%,P<0.01),住院时间更短(6.25±0.25比11.50±0.25,P<0.01),血尿消退时间更快(12.25±4.12比108.15±6.14,P<0.01),治疗显著率更高(95.45%比18.18%,P<0.01),再次住院率明显低于对照组(P<0.05)。结论复合性双侧PAE术后止血效果可靠、住院时间较短,复合性双侧PAE术对于难治性前列腺出血患者具有安全有效的临床应用价值,对血尿患者提供一种有益的补救措施,降低前列腺出血复发率,缩短住院时间,值得临床推广。Objective To assess the efficacy of bilateral prostate arteries embolization(PAE)in the treatment of refractory prostatogenic hematuria(RHPO)in the elderly and high-risk patients.Methods From November 2018 to November 2021,44 elderly patients with high-risk RHPO,who could not tolerate surgery were divided into two study groups.The observation group(22)was treated with bilateral PAE whereas the control group(22)was treated with medications and urethral catheter traction.The success rate of hemostasis,recurrence rate of bleeding,and complications of the two groups were compared to evaluate the efficacy of PAE for RHPO.Results PAE was successful in 21/22(95.45%)patients with 100%hemostasis at 48 hours.Compared with the control group,PAE group had significantly(all P<0.01)lower rate of rebleeding at 6 months(4.54%),lower incidence of deep vein thrombosis(0%),shorter hospital stay[(6.25±0.25)days],faster hematuria regression[(12.25±4.12)hours],higher treatment effective rate(95.45%)than the control group[72.72%,18.18%,(11.50±0.25)days,(108.15±6.14)hours,18.18%].Repeat hospitalization was significantly less in the PAE group than the control group(P<0.05).Conclusion The hemostatic effect of bilateral PAE is reliable with shorter hospitalization and lower rate of recurrent bleeding.It is safe and effective treatment for patients with refractory prostatogenic hematuria.

关 键 词：复合性栓塞 前列腺动脉 血尿 

分 类 号：R815[医药卫生—放射医学] R699[医药卫生—临床医学]