CAJ | 학술논문

目的探讨和评价尿道内切开或(和)瘢痕电切术后,192Ir腔内放疗预防男性尿道再狭窄的安全性和临床疗效.方法 2年余内共治疗48例,其中年龄18～81岁,狭窄长度为0.5～5.5cm,90%狭窄长度在3.0 cm以内.外伤性狭窄23例、前列腺增生术后狭窄19例、不明原因狭窄6例.经尿道造影或内窥镜检查确诊.26例首次治疗,22例再次治疗(首次治疗属非放疗疗法).放疗处方剂量为14～18 Gy.结果 48例平均随访10个月,有效率98%.治疗后无复发,无明显副作用.47例排尿均通畅,最大尿流率13.9～36.4(19.2±10.3)ml/s;1例出现轻度尿失禁,可能与多次扩张损伤尿道括约肌有关.结论尿道内切开或(和)瘢痕电切术后腔内放疗有助于预防尿道再狭窄,明显优于现有其他治疗方法,且副作用小、简便易行.
목적 탐토화평개뇨도내절개혹(화)반흔전절술후,192Ir강내방료예방남성뇨도재협착적안전성화림상료효.방법 2년여내공치료48례,기중년령18～81세,협착장도위0.5～5.5cm,90%협착장도재3.0 cm이내.외상성협착23례、전렬선증생술후협착19례、불명원인협착6례.경뇨도조영혹내규경검사학진.26례수차치료,22례재차치료(수차치료속비방료요법).방료처방제량위14～18 Gy.결과 48례평균수방10개월,유효솔98%.치료후무복발,무명현부작용.47례배뇨균통창,최대뇨류솔13.9～36.4(19.2±10.3)ml/s;1례출현경도뇨실금,가능여다차확장손상뇨도괄약기유관.결론 뇨도내절개혹(화)반흔전절술후강내방료유조우예방뇨도재협착,명현우우현유기타치료방법,차부작용소、간편역행.
Objective To evaluate the safety and efficacy of 192Ir intraluminal brachytherapy for the prevention of urethral re-stricture after transurethral incision or transurethral resection of scar. Methods From Mar. 2004 to Jun. 2006,48 patients aging 18-81 years were treated by 192Ir intraluminal brachytherapy. The length of stricture(0.5-5.5 era) was≤3.0 cm in 90% of the patients. The stricture was caused by trauma in 23 patients and prostate hyperplasia operation in 19 patients. The cause of remaining 6 patients was unclear. All patients were diagnosed by urethra photograph or endoscopy. Radiotherapy was the initial treatment in 26 patients and the second time treatment in 22. The irradiation dose was from 14 Gy to 18 Gy.Results The median follow up was 10 months,and the total response rate was 98%. Only one patient recurred and received transurethral incision again. The uresis was fluency in 47 patients and the maximum flow rate was 13.9-36.4(19.2±10.3) ml/s. No secondary urethral bleeding or urethral cancer was observed.Conclusions Being a safe and feasible treatment, ,192Ir intraluminal brachytherapy following transurethral incision or transurethral resection of scar can effectively prevent urethral re-stricture.