125Ⅰ粒子植入术治疗前列腺癌尿路并发症的临床分析

目的探讨前列腺癌¹²⁵Ⅰ粒子植入术后尿路不良反应及其并发症。 方法回顾性分析2011~2019年在经直肠超声引导下，经会阴前列腺¹²⁵Ⅰ永久性放射粒子植入治疗前列腺癌患者资料，观察尿路并发症以及下尿路症状。 结果共收集120例前列腺癌患者，随访时间2年，平均年龄（73±5）岁；临床Gleason评分6~10分，平均（8.4±1.1）分；前列腺体积（47±12） ml。患者术前、术后1个月、术后3个月、术后半年、术后1年和术后2年IPSS评分分别为：（13.1±3.6），（21.6±4.6），（19.2±4.4），（15.9±3.9），（13.9±3.1）和（13.5±2.7）。术后1个月内尿路Ⅰ级和Ⅱ级并发症发生率分别为14.2%、5.8%；术后3个月尿路Ⅰ级和Ⅱ级并发症发生率分别为5.0%、2.5%。术后无尿路Ⅲ级和Ⅳ级并发症发生。 结论¹²⁵Ⅰ粒子永久植入术治疗前列腺癌是一种微创、术后恢复快的治疗方法。虽然放射性粒子对患者的排尿有一定的影响，但程度较轻，具有一定的自限性。术中精确的定位、制定计划及粒子植入操作技术是预防严重合并症的关键。

Clinical analysis of urinary complications of brachytherapy in patients of prostate cancer

ObjectiveTo analyze the side effects and complications in prostate cancer patients treated with brachytherapy. MethodsA total of 120 prostate cancer patients with average age of (73±5) years were recruited. All the patients were diagnosed as prostate cancer and accepted prostate brachytherapy from 2011 to 2019 under the guidance of transrectal ultrasound. The adverse reactions of urinary tract and their complications after prostate cancer ¹²⁵I seed implantation were analyzed retrospectively. ResultsA total of 120 patients with prostate cancer were collected and the clinical average Gleason score was (8.4±1.1). The IPSS scores of the patients were (13.1±3.6), (21.6±4.6), (19.2±4.4), (15.9±3.9), (13.9±3.1) and (13.5±2.7) before operation, 1 month after operation, 3 months after operation, half a year after operation, 1 year after operation and 2 years after operation, respectively. The incidence of grade I and grade II complications was 14.2% and 5.8% respectively within 1 month after operation, and 5.0% and 2.5% respectively within 3 months after operation. There were no grade III or IV complications. ConclusionsProstate brachytherapy is a minimally invasive treatment for prostate cancer. Although the implantation of particles has a certain impact on the urination of patients, but the degree is relatively light, with a certain degree of self-limiting. Intraoperative accurate localization and making accurate implantation plan are factors to the prevention of serious complications.