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目的探讨晚期前列腺癌诊断和治疗方法的临床价值和意义。方法回顾分析52例晚期前列腺癌患者资料,随访患者症状改善情况及血清PSA等。用配对样本t检验方法分析处理治疗前后有关计量资料数据。所有患者均采用口服抗雄激素药物内分泌治疗(口服氟他胺或康士德);49患者采用双侧睾丸切除;17例排尿困难症状严重者加用姑息性经尿道前列腺汽化电切术,23例骨性疼痛患者服用唑来膦酸等。结果17例接受姑息性经尿道前列腺汽化电切术患者中1例术后10天死于急性心肌梗塞,其余16例患者下尿路梗阻症状缓解(缓解率94.1%)。69.6%患者(16/23)骨痛不同程度缓解,94.2%(49/52)血清PSA下降。各组数据前后对比均有统计学意义。结论①晚期前列腺癌患者经过以内分泌治疗为主的综合治疗,可缓解痛苦,提高生存质量。②姑息性经尿道前列腺汽化电切术是解除下尿路梗阻症状的有效方法。③唑来磷酸联合内分泌治疗可缓解前列腺癌骨转移引起的疼痛。
Objective To investigate the clinical value and significance of the diagnosis and treatment of advanced prostate cancer. Methods A retrospective analysis of 52 cases of advanced prostate cancer patients, follow-up of patients with symptoms and serum PSA and so on. Paired sample t test method for analysis and treatment of measurement data before and after treatment data. All patients were treated with oral anti-androgen therapy endocrine therapy (oral flutamide or Constance); 49 patients with bilateral orchiectomy; 17 cases of dysuria severe symptoms plus palliative transurethral resection of the prostate, 23 cases Patients with bone pain taking zoledronic acid and so on. Results Of 17 patients who underwent palliative transurethral resection of prostatectomy, 1 died of acute myocardial infarction 10 days after operation. The remaining 16 patients had relieved the symptoms of lower urinary tract obstruction (response rate 94.1%). 69.6% of the patients (16/23) relieved to varying degrees, 94.2% (49/52) decreased serum PSA. Before and after each group of data were statistically significant. Conclusion ① advanced prostate cancer patients after endocrine therapy-based comprehensive treatment, can ease the pain and improve the quality of life. Palliative transurethral vaporization of prostate is an effective way to relieve the symptoms of lower urinary tract obstruction. ③ zoledronic acid and endocrine therapy can relieve the pain caused by bone metastasis of prostate cancer.