经尿道前列腺等离子电切术联合内分泌治疗晚期前列腺癌合并膀胱出口梗阻的疗效

摘要

目的:探讨经尿道前列腺等离子电切术(PKRP)联合内分泌治疗晚期前列腺癌合并膀胱出口梗阻的疗效.方法:选择泌尿科就诊的晚期前列腺癌合并膀胱出口梗阻患者90例.采用随机数字表将90例患者分为联合组(45例)与对照组(45例).联合组患者予以PKRP联合内分泌治疗,对照组患者予以单纯的内分泌治疗,疗效均为6个月.观察并比较治疗前和治疗6个月后最大尿流率(Qmax)、残余尿量(RU)、血总前列腺特异性抗原(TPSA)、国际前列腺症状评分(IPSS)和生活质量指数评分(QOL)水平的变化.结果:两组患者治疗前QOL评分、Qmax、RU、IPSS评分和TPSA水平比较差异无统计学意义(P＜0.05).治疗6个月后,两组患者QOL及Qmax均较前明显上升,RU、IPSS评分和TPSA水平较前明显减少(P ＜0.05或P＜0.01),且联合组QOL评分、Qmax、RU、IPSS评分变化幅度较对照组更明显(P＜0.05),但治疗后两组TPSA水平差异无统计学意义(P＞0.05).结论:PKRP联合内分泌治治疗晚期前列腺癌伴合并膀胱出口梗阻的患者的疗效明显优于单纯的内分泌治疗,能明显改善膀胱出口梗阻引起的排尿困难症状,提高最大尿流率,减少残余尿量,提高生活质量.%Objectives:To discuss the curative effect of transurethral plasma kinetic resection of prostate (PKRP) combined with incretion treatment on advanced prostate cancer and bladder outlet obstruction (BOO).Methods:90 patients with advanced prostate cancer and BOO,who were given the medical treatment in Department of Urinary Surgery,were selected and divided into combined group (n =45) and control group (n =45) by table of random number.The patients in combined group were given transurethral PKRP combined with incretion,while the patients in control group were only given incretion treatment for the course of treatment for 6 months.The changes in Qmax,residual urine volume (RU),total prostate specific antigen (TPSA),international prostate symptom score (IPSS) and quality of life (QOL) index score levels of patients in the two groups were observed and compared before and 6 months after medical treatment.Results:Difference in the QOL scores,Qmax,RU,IPSS and TPSA levels of patients between the two groups before medical treatment was not statistically significant (P ＜ 0.05).After 6 months' medical treatment,QOL and Qmax of patients in the two groups obviously increased,while RU,IPSS scores and TPSA levels of patients in the two groups obviously declined (P ＜ 0.05 or P ＜ 0.01),both more significant in the observation group (P ＜ 0.05),but difference in the TPSA levels after medical treatment was not statistically significant (P ＞ 0.05).Conclusion:PKRP combined with incretion treatment is more effective in treating advanced prostate cancer and BOO.It can obviously improve the dysuresia due to BOO,raise Qmax and reduce RU,hereby raising the IPSS and enhancing life quality.