经尿道前列腺癌等离子电切术治疗晚期前列腺癌尿潴留的临床研究  

Clinical Study of Transurethral Prostate Cancer Plasma Resection Treatment on Urinary Retention and Micturition in Advanced Prostate Cancer

作　　者：张格金 徐玉龙 郭建[1] 陈波[2] 马雨阳 许浩 潘登 庞昆[2] Zhang Gejin;Xu Yulong;Guo Jian(Department of Urology,Zhongwu Hospital,Suqian,Jiangsu,223800,China)

机构地区：[1]宿迁市钟吾医院泌尿外科,江苏宿迁223800 [2]徐州市中心医院·徐州医学院徐州临床医学院泌尿外科,江苏徐州221009 [3]蚌埠医学院研究生院,安徽蚌埠233030

出　　处：《黑龙江医学》2024年第12期1440-1442,1446,共4页Heilongjiang Medical Journal

基　　金：徐州市引进临床医学专家团队项目(2018TD004);中国博士后基金面上项目(2022M722674);江苏省妇幼保健协会项目(FYX202026);徐州市医学后备人才计划项目(XWRCHT20220009)。

摘　　要：目的:观察经尿道前列腺癌等离子电切术(TuPkR-PCa)对晚期前列腺癌伴尿潴留(APCa-UR)患者排尿症状的改善效果。方法:回顾性分析2016年6月—2020年5月宿迁市钟吾医院和徐州市中心医院就诊的51例APCa-UR患者临床资料。根据治疗方式不同,将患者分为两组。非手术组(34例):留置尿管,同时予醋酸阿比特龙及戈舍瑞林内分泌治疗,每4周试拔除尿管,若不能自行排尿或残余尿仍大于70 mL,则再次留置尿管,直至可自行排尿及残余尿小于70 mL。手术组(17例):采用TuPkR-PCa切除部分前列腺组织,术后1周拔除尿管,并同时辅以阿比特龙及戈舍瑞林内分泌治疗。随访比较两组肿瘤指标、国际前列腺症状评分表(IPSS)及手术组术前术后排尿情况等数据。结果:两组患者基线资料比较,差异无统计学意义(χ^(2)=0.362、0.012、0,P>0.05);治疗前1周两组患者IPSS评分、前列腺特异性抗原(PSA)、前列腺体积等比较,差异无统计学意义(t=-0.120、0.870、-0.510、-0.620,P>0.05);治疗后3个月,TuPkR-PCa较内分泌治疗对改善APCa-UR症状效果明显,差异有统计学意义(t=9.070,P<0.05)。结论:在晚期前列腺癌伴尿潴留患者的治疗中,TuPkR-PCa可以在不改变肿瘤学特性的情况下,有效改善前列腺癌伴尿潴留患者生活质量。Objective:To observe the effect of transurethral plasma resection of Prostate Cancer(TuPkR-PCa)on the improvement of urination symptoms in patients with advanced prostate cancer with urinary retention(APCa-UR).Methods:A retrospective study was performed on 51 patients with APCa-UR admitted in Suqian Zhongwu Hospital and Xuzhou Central Hospital from June 2016 to May 2020.Patients were divided into two groups according to different treatment methods.Non-surgical group(34 patients):indwelling urinary catheter,simultaneous abiraterone acetate and goserelin endocrine therapy,to try to remove the catheter every 4 weeks.If it is not possible to urinate or residual urine was greater than 70 mL,the catheter was placed again.Surgical group(17 patients):TuPkR-PCa was performed to remove the transitional band prostate tissue,the urinary catheter was removed 1 week after the operation,and supplemented with abiraterone and goserelin endocrine therapy.Oncological index,IPSS and urinating condition of two groups before and after operation were compared.Results:There was no significant difference in baseline data between groups(χ^(2)=0.362,0.012,0;P>0.05).IPSS score,PSA and prostate volume between the two groups 1 week before treatment,with no statistically significant difference(t=-0.120,0.870,-0.510,-0.620;P>0.05).3 months after treatment,TuPkR-PCa was more effective than endocrine therapy in improving APCa-UR symptoms,with statistically significant difference(t=9.070,P<0.05).Conclusion:In the treatment of APCa-UR patients,TuPkR-PCa can effectively improve the quality of life without changing the oncological characteristics.

关 键 词：晚期前列腺癌 尿潴留 经尿道前列腺癌等离子电切术 疗效 肿瘤学指标 

分 类 号：R737.25[医药卫生—肿瘤]