经尿道前列腺电切术联合内分泌治疗晚期前列腺癌的效果分析  

Effect Analysis of Transurethral Resection of Prostate Combined with Endocrine Therapy for Advanced Prostate Cancer

作　　者：谢平波 刘明生 周红庆 武绍梅 邵涛 郭峰 XIE Pingbo;LIU Mingsheng;ZHOU Hongqing;WU Shaomei;SHAO Tao;GUO Feng(Dept.of Urology,The 1st People’s Hospital of Qujing,Qujing Yunnan 655000;Clinical Skills Training Center,Kunming Medical University,Kunming Yunnan 650500,China)

机构地区：[1]曲靖市第一人民医院泌尿外科,云南曲靖655000 [2]昆明医科大学临床技能中心,云南昆明650500

出　　处：《昆明医科大学学报》2023年第12期46-50,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(82160584);云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目[202301AY070001-060];云南省教育厅科学研究基金资助项目(2023Y0703);昆明医科大学晚期前列腺癌诊疗科技创新团队基金资助项目(CXTD202216);昆明医科大学附属曲靖医院院级科研基金资助项目(2020YJKT 03)。

摘　　要：目的探讨经尿道前列腺电切术联合内分泌治疗对于中晚期前列腺癌患者的疗效与安全性。方法回顾性分析2014年1月至2017年12月期间收治87例伴有排尿困难症状的T3b、T4期晚期前列腺癌患者,分为2组。TURP组(n=48),接受经尿道前列腺电切术治疗,术后再辅以规律内分泌治疗;对照组(n=39),单纯予以规律内分泌治疗。对比分析2组治疗前后前列腺特异性抗原、最大尿流率、残余尿量、国际前列腺症状评分(IPSS评分)、5 a生存率等指标。结果TURP组术后3个月排尿困难症状缓解明显,各项指标较术前明显改善。PSA指标也较术前明显下降。在治疗3个月后,TURP组的IPSS、Qmax、RV、PSA指标较对照组明显改善(P<0.05)。2组患者在接受规范的治疗后PSA均值都逐渐下降,在刚开始治疗的12个月里,TURP组较对照组PSA均值下降更明显,但在治疗12个月后,2组的PSA均值对比差异无统计学意义(P=0.056)。对2组患者随访5 a,对比分析发现2组的生存差异无统计学意义(P=0.734)。结论TURP联合规律内分泌治疗能有效改善前列腺癌患者排尿困难症状,明显提升患者生活质量,同时并不会影响患者5 a生存率,是一种安全有效的治疗方式。Objective To evaluate the efficacy and safety of transurethral resection of Prostate(TURP)combined with endocrine therapy in patients with advanced prostate cancer.Methods A retrospective analysis was conducted on 87 cases of late-stage prostate cancer with dysuria admitted between January 2014 and December 2017.We divided them into 2 groups.TURP group(n=48)received transurethral resection of prostate,followed by regular endocrine therapy.The control group(n=39)was only given regular endocrine therapy.Comparative analysis of indicators such as prostate-specific antigen before and after treatment,maximum urinary flow rate,residual urine volume,International Prostate Symptom Score(IPSS),and 5-year survival rate was performed between the two groups.Results Three months after TURP surgery,the symptoms of urinary difficulty significantly improved,and various indicators showed significant improvement compared to before the surgery.PSA levels also notably decreased compared to before the surgery.After 3 months of treatment,the TURP group showed significant improvements in IPSS,Qmax,RV,and PSA indicators compared to the control group(P<0.05).Both groups of patients experienced a gradual decrease in PSA levels after receiving standardized treatment.In the first 12 months of treatment,the PSA levels in the TURP group decreased more significantly compared to the control group,but after 12 months of treatment,the comparison difference was not statistically significant in the PSA levels between the two groups(P=0.056).A 5-year follow-up comparison of the two groups of patients revealed that there was no statistically significant difference in survival(P=0.734).Conclusion Transurethral resection of Prostate(TURP)combined with regular endocrine therapy can effectively improve the dysuria in prostate cancer patients,improve the quality of life of patients,and will not affect the five-year survival rate.TURP is a safe and effective treatment for advanced prostate cancer.

关 键 词：经尿道前列腺电切术 内分泌治疗 晚期前列腺癌 5a生存率 

分 类 号：R69[医药卫生—泌尿科学]