CAJ | 학술논문

目的探讨经尿道汽化切除术在伴有膀胱出口梗阻的前列腺癌治疗中的应用价值.方法伴膀胱出口梗阻(BOO)症状的前列腺癌(PCa)患者33例.对18例术前确诊经治疗后仍存在梗阻的PCa患者,手术以切除引起梗阻的癌组织,使尿路通畅为目的 .对15例术前未确诊患者按良性前列腺增生(BPH)切除,7例患者术中冷冻切片确诊PCa后,同时行睾丸切除术.8例患者术后病理确诊后再行睾丸切除术和(或)抗雄激素治疗.结果 33例患者手术均成功.术后暂时性尿失禁5例,肉跟血尿9例.27例患者随访10～36个月.死于PCa 8例,平均生存31个月.死于其他原因5例.术后3个月时血清前列腺特异性抗原(PSA)为(10.2±6.7)μg/L;剩余尿量平均(39.7±13.9)ml;国际前列腺症状评分(IPSS)为(8.7±1.6)分.各项指标与术前相比,差异均有统计学意义(P<0.05).结论经尿道汽化切除术对伴有膀胱出口梗阻的前列腺癌有可靠的治疗作用,且在特定的情况下有协助诊断的作用.
목적 탐토경뇨도기화절제술재반유방광출구경조적전렬선암치료중적응용개치.방법 반방광출구경조(BOO)증상적전렬선암(PCa)환자33례.대18례술전학진경치료후잉존재경조적PCa환자,수술이절제인기경조적암조직,사뇨로통창위목적 .대15례술전미학진환자안량성전렬선증생(BPH)절제,7례환자술중냉동절편학진PCa후,동시행고환절제술.8례환자술후병리학진후재행고환절제술화(혹)항웅격소치료.결과 33례환자수술균성공.술후잠시성뇨실금5례,육근혈뇨9례.27례환자수방10～36개월.사우PCa 8례,평균생존31개월.사우기타원인5례.술후3개월시혈청전렬선특이성항원(PSA)위(10.2±6.7)μg/L;잉여뇨량평균(39.7±13.9)ml;국제전렬선증상평분(IPSS)위(8.7±1.6)분.각항지표여술전상비,차이균유통계학의의(P<0.05).결론 경뇨도기화절제술대반유방광출구경조적전렬선암유가고적치료작용,차재특정적정황하유협조진단적작용.
Objective To evaluate the application of the transurethral vapor-resection of the prostate(TU- VRP) for bladder outlet obstruction(BOO) in patients with prostate eaneer(PCa). Methods Of 33 patients with BOO. 18 were definitely diagnosed with PCa and after treatment they still had symptoms of BOO;15 cases were di- agnosed with benign prostate hyperplasia(BPH). All patients underwent TUVRP for BOO. Results All cases were successfully done. Postoperative complications included transient urinary ineontinenee in 5 ,and gross hematuria in 9. 27 patients were followed up(10-36 months).8 cases died of PCa,with a mean survival of 31 months.5 cases died of other diseases. After treatment, PSA levels decreased to ( 10.2 ± 6.7) μg/L. The average residual urinary volume (RU) decreased to (39.7 ± 13.9) ml, and the average IPSS was (8.7 ± 1.6 ). Compared with those of preoperation, the differences were statistically significant ( P < 0.05 ). Conelnsion TUVRP is a reliable treatment for prostate cancer with bladder outlet obstruction.