前列腺癌患者125I近距离放射治疗后发生急性尿潴留的多因素分析

目的分析125I治疗前列腺癌(Brachytherapy)后发生急性尿潴留的各种因素,提出预见性因素,为临床评估及干预提供依据,改进125I植入方法,减少急性尿潴留并发症的发生率。方法我院2008年7月～2011年3月,126例前列腺癌患者行经直肠125I粒子植入,对于发生急性尿潴留的患者,从临床相关,治疗相关两大因素进行综合分析。结果126例125I植入的前列腺癌患者中15例发生了急性尿潴留,均行保留导尿。发生急性尿潴留的时间中位数为植入粒子的第2d(1～7d),保留导尿的时间中位数为7d(4～10d)。单变量分析临床相关,治疗相关因素,再行多因素综合分析,发现穿刺进针数(Number of needles),125I植入前IPSS评分(pre-implant IPSS),植入前前列腺B超体积(pre-implant US prostatevolume),植入125I的粒子数量(number of seeds)与急性尿潴留之间是有统计学意义的(P<0.05),多因素分析number ofneedles,pre-implant IPSS最有意义(P<0.01)。结论 number of needles及pre-implant IPSS可以做为125I近距离放射治疗前列腺癌患者是否发生急性尿潴留的可预见性因素。

Multiplicity of acute urinary retention following 125Iprostate brachytherapy

Objective To analyze various fctors of acute urinary retention following 125I prostate brachytherapy and to raise predictive factors.thus,we can provide evidence for clinical assessment and clinical interference.we also can improve implantation method of 125I brachytherapy to reduce incidence of acute urinary retention.Methods A group of 126 consecutive patients with prostate clinical,treatment-related were evaluated for the need for catheterization owing to urinary retention.Results Fifteen patients(12%) required catheterization.The median time to onset was 2 days after implantation(range 1～7 days).The median duration of catheterization for urinary retention was 7 days(range 4～10 days).Univariate analysis demonstrated that number of needles,pre-implant IPSS,pre-implant US prostate volume and number of seeds were predictive for catheterization.In multivariate analysis,number of needles and pre-implant IPSS were significant indendent priditive factors for catheterization.Conclusion Our data suggest that the number of needles and pre-implant IPSS might be the strongest predictors for catheterization.