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目的:探讨经尿道选择性绿激光汽化术(PVP)联合全雄激素阻断治疗晚期前列腺癌伴膀胱颈梗阻患者的临床疗效。方法:回顾性分析15例应用PVP联合全雄激素阻断治疗晚期前列腺癌伴膀胱颈梗阻患者的临床资料,观察患者手术时间、留置导尿管时间、术前后前列腺体积、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Q_(max))、剩余尿(PVR)及前列腺特异性抗原(PSA)的变化。结果:所有手术均成功,无输血及前列腺电切综合征现象。手术时间40～120 min,术后留置导尿管时间3～5天。术前前列腺体积、IPSS以及QOL分别为(95.13±16.36)ml、(19.87±4.10)分、(3.67±1.23)分,术后1个月分别为(48.47±11.55)ml、(12.27±3.24)分、(2.00±1.25)分(P均<0.01);术前Q_(max)、PVR分别为(8.05±2.51)ml/s、(136.47±32.16)ml,术后1个月分别为(18.40±4.63)ml/s、(33.87±13.44)ml(均P<0.01);术前PSA为(78.00±29.11)μg/L,术后1个月、3个月分别为(1.32±0.70)μg/L、(0.48±0.07)μg/L(均P<0.01)。结论:PVP联合全雄激素阻断治疗晚期前列腺癌伴膀胱颈梗阻是安全有效的,可以明显缓解患者的症状,抑制肿瘤进展,提高患者的生活质量。
Objective: To investigate the clinical efficacy of transurethral selective green laser vaporization (PVP) combined with whole androgen blockade in patients with advanced prostate cancer and bladder neck obstruction. Methods: The clinical data of 15 patients with advanced prostate cancer and bladder neck obstruction treated by PVP combined with androgen androgen were retrospectively analyzed. The operative time, indwelling catheter time, preoperative and postoperative prostate volume, international prostate symptom score ( IPSS, QOL, Qmax, residual urine (PVR) and prostate specific antigen (PSA) were measured. Results: All operations were successful without transfusion and prostate resection syndrome. Surgery time 40 ~ 120 min, postoperative indwelling catheter for 3 to 5 days. The preoperative prostate volume, IPSS and QOL were (95.13 ± 16.36) ml and (19.87 ± 4.10) and (3.67 ± 1.23) points, respectively, and were 48.47 ± 11.55 and 12.27 ± 3.24 respectively at 1 month after operation. (P <0.01). Preoperative Q max and PVR were (8.05 ± 2.51) ml / s and (136.47 ± 32.16) ml, respectively, and were 1.80 (P <0.01). The preoperative PSA was (78.00 ± 29.11) μg / L and the postoperative 1 month and 3 months were (1.32 ± 0.70) μg / L and / L, (0.48 ± 0.07) μg / L (all P <0.01). Conclusion: The combination of PVP and androgen blockade in the treatment of advanced prostate cancer with bladder neck obstruction is safe and effective. It can relieve the symptoms of patients, inhibit tumor progression and improve the quality of life of patients.