中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2011年
5期
340-342
,共3页
高远%苏顺业%刘鲁东%臧运江%王沈阳%张明荣%周全%曾绍文%乔梁
高遠%囌順業%劉魯東%臧運江%王瀋暘%張明榮%週全%曾紹文%喬樑
고원%소순업%류로동%장운강%왕침양%장명영%주전%증소문%교량
前列腺肿瘤%睾丸%附睾%睾丸切除术%睾酮
前列腺腫瘤%睪汍%附睪%睪汍切除術%睪酮
전렬선종류%고환%부고%고환절제술%고동
Prostatic neoplasms%Testis%Epididymis%Orchiectomy%Testosterone
目的 比较保留附睾的睾丸切除术(A组)与传统睾丸切除术(B组)在进展期前列腺癌治疗中的疗效,探讨睾丸去势治疗的最佳选择方式.方法 进展期前列腺癌60例,A、B组各30例.均在局麻下行单切口双侧睾丸切除术,术后第1天起口服非类固醇类雄激素阻断剂.分别于术前、术后1周及l、3、6、9、12个月,观察2组血清总睾酮、前列腺特异性抗原(PSA)变化；了解患者手术满意度等.结果 去势术后12个月,A、B组血清睾酮平均水平分别为0.2 nmol/L(95％置信区间0.1～0.9 nmol/L)、0.3 nmol/L(95％置信区间0.2～0.9 nmol/L),均＜1.9 nmol/L,2组均数比较,P＞0.05;A组PSA平均值0.22 ng/ml,B组0.27 ng/ml,2组均数比较,P＞0.05.问卷调查示A组满意度为96.7％ (29/30),B组为53.3％ (16/30).结论 2种睾丸切除术在进展期前列腺癌治疗中疗效无明显差异,但保留附睾的睾丸切除术、附睾成形术有助于满足患者的阴囊外观形态和心理需要.
目的 比較保留附睪的睪汍切除術(A組)與傳統睪汍切除術(B組)在進展期前列腺癌治療中的療效,探討睪汍去勢治療的最佳選擇方式.方法 進展期前列腺癌60例,A、B組各30例.均在跼痳下行單切口雙側睪汍切除術,術後第1天起口服非類固醇類雄激素阻斷劑.分彆于術前、術後1週及l、3、6、9、12箇月,觀察2組血清總睪酮、前列腺特異性抗原(PSA)變化；瞭解患者手術滿意度等.結果 去勢術後12箇月,A、B組血清睪酮平均水平分彆為0.2 nmol/L(95％置信區間0.1～0.9 nmol/L)、0.3 nmol/L(95％置信區間0.2～0.9 nmol/L),均＜1.9 nmol/L,2組均數比較,P＞0.05;A組PSA平均值0.22 ng/ml,B組0.27 ng/ml,2組均數比較,P＞0.05.問捲調查示A組滿意度為96.7％ (29/30),B組為53.3％ (16/30).結論 2種睪汍切除術在進展期前列腺癌治療中療效無明顯差異,但保留附睪的睪汍切除術、附睪成形術有助于滿足患者的陰囊外觀形態和心理需要.
목적 비교보류부고적고환절제술(A조)여전통고환절제술(B조)재진전기전렬선암치료중적료효,탐토고환거세치료적최가선택방식.방법 진전기전렬선암60례,A、B조각30례.균재국마하행단절구쌍측고환절제술,술후제1천기구복비류고순류웅격소조단제.분별우술전、술후1주급l、3、6、9、12개월,관찰2조혈청총고동、전렬선특이성항원(PSA)변화；료해환자수술만의도등.결과 거세술후12개월,A、B조혈청고동평균수평분별위0.2 nmol/L(95％치신구간0.1～0.9 nmol/L)、0.3 nmol/L(95％치신구간0.2～0.9 nmol/L),균＜1.9 nmol/L,2조균수비교,P＞0.05;A조PSA평균치0.22 ng/ml,B조0.27 ng/ml,2조균수비교,P＞0.05.문권조사시A조만의도위96.7％ (29/30),B조위53.3％ (16/30).결론 2충고환절제술재진전기전렬선암치료중료효무명현차이,단보류부고적고환절제술、부고성형술유조우만족환자적음낭외관형태화심리수요.
Objective To compare epididymis-sparing orchiectomy (group A) with traditional orchiectomy (group B ) in patients with advanced prostate cancer,and to evaluate which procedure is better.Methods A total of 60 cases of advanced prostate cancer patients were enrolled,with 30 cases in group A and 30 cases in group B.They were given oral anti-androgen from 1 day after castration.Serum level of testosterone and prostatic specific antigen (PSA) was detected before castration,and 1 week,1,3,6,9 and 12 months after castration.Patient satisfaction was also evaluated.Results On time point of 12 months after castration,the average level of serum testosterone was 0.2 nmol/L (95 ％ confidence interval,0.1 ～ 0.9 nmol/L) in group A and 0.3 nmol/L (95％ confidence interval,0.2 ～ 0.9 nmol/L) in group B (P ＞0.05 ) ; the average value of PSA was 0.22 ng/ml in group A and 0.27 ng/ml in group B (P ＞0.05 ) ; patient satisfaction rate was 96.7％ (29/30) in group A and 53.3％ (16/30) in group B.Conclusions No significant difference of testosterone level and PSA is found between the 2 groups.However,epididymis-sparing orchiectomy meets the psychological needs better because it helps to maintain the appearance of the scrotum through epididymis preservation and epididymoplasty.
