Objective To discuss the clinical efficacy and safety of high intensity focused ultransound ( HIFU ) in the treatment of benign prostatic hyperplasia ( BPH ). Methods Sixty cases of benign prostatic hyperplasia were treated with the Sonablat - 500TM therapeutic system. Parameters of transrectal color Doppler flow imaging ( CDFI ) before and after treatment were compared to evaluate the hemodynamic changes in the prostate. Efficacy was evaluated via imaging changes, urine analysis, IPSS, QOL scores, Qmax , and postvoidresidual ( PVR ) before and 1, 2, 6, 12 months after treatment respectively. Results IPSS, QOL scores, PVR, prostate volume, Vs, Vd, resistive index ( RI), acceleration index ( AI), and inside diameters ( D ) decreased gradually, while Qmax increased gradually, with statistical significance at the following time points : before treatment, 1 month, 2 months, 6 months, and 12 months after treatment ( P ＜ 0.05 ). Conclusion HIFU prostate ablation is safe, efficacious, less invasiveness and with minimal complications in treating BPH. Therapeutic effects of finasteride on BPH can be evaluated by hemodynamic parameters detected by transrectal CDFI.%目的 探讨经直肠高强度聚焦超声(HIFU)治疗良性前列腺增生(BPH)的有效性和安全性.方法 对60例BPH 患者采用 Sonablate 500 型"经直肠超声聚能刀"进行前列腺消融术,通过对彩色多普勒(CDFI)参数的对比分析,客观评价前列腺内血流动力学变化特征.术前、治疗后1个月、2个月、6个月和12个月,经直肠超声观察前列腺和前列腺部尿道的影像学变化,通过尿液分析、国际前列腺症状(IPSS)评分、生活质量(QOL)评分、最大尿流率(Qmax)和残余尿量(PVR)进行疗效评估.结果 随访12个月,治疗前、治疗后1个月、2个月、6个月和12个月患者IPSS评分、QOL评分逐渐减小,Qmax逐渐升高,PVR逐渐降低,前列腺体积逐渐减小,动脉收缩期峰值速度(Vs)、舒张末期速度(Vd)、阻力指数(RI)、加速指数(AI)、血管内径(D)均逐渐降低,差异有统计学意义(P＜0.05).结论 "经直肠超声聚能刀"前列腺消融术,能对前列腺组织进行选择性破坏,具有微创(无血手术)、安全和并发症少等优点.经直肠彩色多普勒超声为其疗效评估提供了一种直观,准确的方法.
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