经尿道前列腺电切术联合全雄激素阻断治疗晚期前列腺癌伴膀胱出口梗阻的体会.doc

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1、经尿道前列腺电切术联合全雄激索阻断治疗晚期前列腺癌伴膀胱出口梗阻的体会［摘要］目的探讨经尿道前列腺电切术(TURP)联合全雄激素阻断治疗晚期前列腺癌伴膀胱出口梗阻的效果。方法对52例晚期前列腺癌伴膀胱出口梗阻患者采用TURP+间断全雄激索药物治疗。结果52例手术均顺利，术后排尿困难均明显改善，术后3个月患者血清总前列腺特异性抗原(TPSA)较术前明显下降，最大尿流率(Qnuix)较术前明显升高、残余尿量(RU)较术前明显减少、国际前列腺症状评分(IPSS)、生活质量评分(QOL)较术前明显改善(P均<0.05)。18例骨转移瘤

2、患者骨痛显著减轻或消失。50例获得随访，随访4〜65个月，46例患者长期带瘤生存，3例患者死于前列腺癌。结论TURP联合间断全雄激素阻断治疗晚期前列腺癌伴膀胱出口梗阻的近期疗效确切，能明显改善患者膀胱出口梗阻症状，提高患者的生活质量。［关键词］前列腺癌；膀胱出口槌阻；经尿道前列腺电切术；全雄激素阻断［中图分类号］R737.25［文献标识码］B［文章编号］1673-9701(2011)35-159-02TheExperienceofTransurethralResectionCombinedwithMaximalAndrogen

3、BlockadeTherapyforAdvancedProstateCancerwithBladderOutletObstructionZHANGLeiDepartmentofUrologySurgeryofTaizhouHospitalinZhejiangProvince,Taizhou318000,China［Abstract］ObjectiveToevaluatetheexperienceoftransurethralresection(TURP)combinedwithmaximalandrogenblockadeth

4、erapyforadvaneedprostatecancerwithbladderoutletobstruction.MethodsFiftytwopatientswithadvancedprostatecancerwithbladderoutletobstructionweretreatedwithTURP“ndintermittentmaximalandrogenblockadetherapy.ResuItsFiftytwopatientswereoperatedsuccessfully,andpostoperativev

5、oidingsymptomsweresignificantlyimproved.SerumTPSAdecreasedgreatly,maximumurinaryflowrate(Qmax)wassignificantlyhigher,residualurinevolume(RU)signifiedntlyreducedcomparedwiththatbeforetheoperation,andtheinternationtilprostatesymptomscore(1PSS),qualityoflifescore(QOL)i

6、mprovedsignificantlycomparedwiththosebeforesurgery(allP<0.01).Bonepeinof18patientswithbonemetastaseswassignificantlyreducedorevendisappeared・Allof50caseswerefollowedupfor4to65months,46ofwhichpatientshadlong-1ermsurvival,threepatientsdiedofprostatecancer・ConelusionTU

7、RPcombinedintermittentmaximalandrogenblockadetherapyforadvancedprostatecancerwithbladderoutletobstructioniseffectiveinthenearfuture.Ttcansignificantlyimprovesymptomsinpatientswithbladderoutletobstructionandimprovepatients'qualityoflife.［Keywords］Prostatecancer；Bladd

8、eroutletobstruction；Transurethralresection;Maximalandrogenblockade对晩期前列腺癌进行全雄激素阻断内分泌治疗的疗效肯定，但合并膀胱出口梗阻岀现慢性尿潴留、两肾积水需早期长期留置导尿管或行膀胱造痿，易引起尿路感染、