CAJ | 학술논문

　　目的评价氩氦刀低温冷冻治疗前列腺癌的临床效果。方法采用美国ENDOCARE公司制造的CRYDCARE低温手术系统进行手术。26例前列腺癌患者在腰麻或硬膜外麻醉下，经直肠超声或腹部超声术中定位监测，实施前列腺超低温治疗。分别于冷冻治疗术后1个月和3个月时，在直肠超声引导下行前列腺穿刺活检并进行病理检查。结果术后穿刺病理结果显示，肿瘤阴性19例，阳性7例。治疗后排尿梗阻症状均有好转，血尿减轻或消失。26例随访3～24个月，血清前列腺特异性抗原（PSA）明显降低，骨转移灶部分消失或缩小，骨痛缓解。其中20例恢复自行排尿。术后3～24个月患者PSA均＜4ng/ml。结论氩氦刀低温冷冻术后配合使用雄激素阻断药物，治疗前列腺癌效果良好，具有住院时间短、不失血、创伤小、恢复快的特点。
　　목적평개아양도저온냉동치료전렬선암적림상효과。방법채용미국ENDOCARE공사제조적CRYDCARE저온수술계통진행수술。26례전렬선암환자재요마혹경막외마취하，경직장초성혹복부초성술중정위감측，실시전렬선초저온치료。분별우냉동치료술후1개월화3개월시，재직장초성인도하행전렬선천자활검병진행병리검사。결과술후천자병리결과현시，종류음성19례，양성7례。치료후배뇨경조증상균유호전，혈뇨감경혹소실。26례수방3～24개월，혈청전렬선특이성항원（PSA）명현강저，골전이조부분소실혹축소，골통완해。기중20례회복자행배뇨。술후3～24개월환자PSA균＜4ng/ml。결론아양도저온냉동술후배합사용웅격소조단약물，치료전렬선암효과량호，구유주원시간단、불실혈、창상소、회복쾌적특점。
Objective To evaluate the clinical efficiency of argon-helium cryoablation for prostate cancer. Methods The ENDOCARE cryosurgical system with 2mm Cryoprobes was used to treat the prostate cancer guided by transrectal ultrasound or abdomen ultrasound in 26 patients with a mean age of 73.2 (ranging from 65 to 89) years in our department from 1990 to 2012. Biopsy of the prostate was carried out under the guide of ultrasound at 1 and 3 months after cryotherapy for pathological observation. Results The patients were all followed up for 3 to 24 months. The biopsy results showed that 19 cases were pathologically negative and 7 cases were positive. The obstructions of bladder outlet were all relieved, and hematuria was attenuated or disappeared. Serum prostatic specific antigen (PSA) level was decreased obviously. Bone metastases partially disappeared or shrunk. Bone pain was relieved to some extent. Twenty of them were able to urinate. All patients had their serum levels of PSA lower than 4ng/ml at 3 to 24 months after cryoablation. Conclusion Cryoablation combined with anti-androgen drug has better clinical outcome in the treatment of prostate cancer, with advantages of short hospitalization period, no blood loss, little injury and rapid recovery.