内分泌治疗联合经尿道前列腺电切术治疗晚期前列腺癌的临床观察

目的 研究晚期前列腺癌患者行内分泌治疗联合经尿道前列腺电切术治疗的临床疗效.方法 选取2012年1月-2013年2月收治的晚期前列腺癌患者60例,按照治疗方法分为对照组和观察组,每组30例.两组均行经尿道前列腺电切术加双侧睾丸切除术治疗,观察组在此基础上联合内分泌治疗.观察两组治疗前后前列腺特异抗原(PSA)水平、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流量及残余尿量,同时比较两组3年生存情况及不良反应.结果 术后,拔出导尿管后可自行排尿患者40例,能进行适当功能训练患者15例,出现充盈性尿失禁状况患者5例.治疗后观察组PSA水平、IPSS评分及残余尿量均低于治疗前和对照组(P＜0.05),QOL评分和最大尿流量均高于治疗前和对照组(P＜0.05).观察组1年、2年和3年生存率均高于对照组(P＜0.05);两组在治疗期间均未出现明显不良反应.结论 对于晚期前列腺癌患者在经尿道前列腺电切术治疗的基础上加用内分泌治疗能更好地改善病情,提高3年生存率.

Clinical Observation of Endocrine Therapy Combined with Transurethral Resection for Prostate in Treatment of Patients with Advanced Prostate Cancer

Objective To study clinical efficacy of endocrine therapy combined with transurethral resection for prostate in treatment of patients with advanced prostate cancer.Methods A total of 60 patients with advanced prostate cancer admitted during January 2012 and February 2013 were divided into control group (n =30) and observation group (n =30) according to treatment methods.All patients were treated with transurethral resection for prostate and bilateral orchiectomy.On the basis,observation group was added endocrine therapy.In two groups,prostate specific antigen (PSA) level,international prostate symptom score (IPSS),quality of life (QOL) score,maximum urinary flow rate and residual urine volume were observed before and after treatment,and 3 years survival conditions and incidence rates of adverse reactions were compared simultaneously.Results After operation,40 patients could voluntary micturition after catheter removal;15 patients could carry out suitable functional training;5 patients had urinary incontinence.After treatment,values of PSA level,IPSS score and residual urine volume in observation group were significantly lower (P ＜0.05),and values of QOL score and maximum urine flow were significantly higher than those before treatment in observation group and in control group (P ＜ 0.05).Survival rates of the 1st years,2nd year and 3rd years in observation group were significantly higher than those in control group (P ＜ 0.05).There was no obvious adverse reaction during the treatment in two groups.Conclusion Endocrine therapy in application of patients with advanced prostate cancer undergoing transurethral resection for prostate can effectively improve pathogenetic condition and postoperative 3 years of survival rates.