首页|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

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

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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(χ2=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(χ2=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.

Advanced prostate cancerUrinary retentionTransurethral resection of prostate cancerEfficacyOncological index

张格金、徐玉龙、郭建、陈波、马雨阳、许浩、潘登、庞昆

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宿迁市钟吾医院泌尿外科,江苏 宿迁 223800

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

蚌埠医学院研究生院,安徽 蚌埠 233030

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

徐州市引进临床医学专家团队项目中国博士后科学基金面上项目江苏省妇幼保健协会项目徐州市医学后备人才计划

2018TD0042022M722674FYX202026XWRCHT20220009

2024

10.3969/j.issn.1004-5775.2024.12.009

黑龙江医学
中华医学会黑龙江分会

黑龙江医学

影响因子：0.714
ISSN：1004-5775
年,卷(期)：2024.48(12)
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