高龄危重患者良性前列腺增生氩氦刀冷冻治疗研究(附21例报告)

目的:评价高龄危重患者BPH经皮冷冻的临床疗效。方法:使用ENDCARE冷冻手术系统,对72～91岁,同时伴有明显心肺功能障碍的21例BPH患者实施B超引导下的氩氦刀冷冻治疗,观察术后前列腺活检、前列腺超声图像、尿流率、血清PSA等变化。结果:术后前列腺组织出现变性、坏死,表现为完全消融现象;氩氦刀治疗前后平均尿流率分别为(3.8±2.1)、(17.0±5.8)ml/s(P<0.01);术前血清PSA(3.7±2.4)μg/L,术后1周(22.6±13.1)μg/L,与术前相比明显增高(P<0.01),术后4周(1.7±1.4)μg/L,与术前相比明显降低(P<0.05)。结论:经皮氩氦刀冷冻治疗BPH近期疗效满意,是高龄危重患者较好的治疗方法。

Cryosurgical Ablation for Aged Patients with Severe Benign Prostate Hyperplasia:A Report of 21 Cases

OBJECTIVE: To study the clinical effect of cryosurgical ablation for aged patients with severe benign prostate hyperplasia. METHODS: Twenty-one 72-91-year-old patients with severe benign prostate hyperplasia accompanied with cardiopulmonary dysfunction were treated by the ENDOCARE cryo-care surgery system with cryo-probes guided by type B ultrasound. Observations were made of the post-operation prostate biopsy and ultrasonogram as well as the changes of the urinary flow rate (UFR) and prostate-specific antigen (PSA). RESULTS: Degeneration and necrosis of the prostate tissues were found after the operation, with the signs of being completely melted. The mean UFRs before and after the operation were (3.8 +/- 2.1) ml/s and (17.0 +/- 5.8) ml/s, respectively (P < 0.01). Compared with the pre-operation level of PSA ([3.7 +/- 2.1] microg/L), the 1-week post-operation level was significantly higher ([22.6 +/- 13.1] microg/L) (P < 0.01), while the 4-week post-operation level significantly lower ([1.7 +/- 1.4] microg/L) (P < 0.05). CONCLUSION: Cryosurgical ablation, with satisfactory short-term curative effect, is a desirable option for the treatment of aged patients with severe benign prostate hyperplasia.