经尿道前列腺电切术治疗晚期前列腺癌伴膀胱出口梗阻的疗效观察

目的：探讨经尿道前列腺电切术（TURP）联合内分泌治疗晚期前列腺癌伴膀胱出口梗阻的疗效及安全性。方法：回顾性分析2007年5月～2012年5月采用TURP联合内分泌治疗拟或单纯内分泌治疗晚期前列腺癌伴膀胱出口梗阻患者32例，其中13例行单纯行内分泌治疗，19例行TURP联合内分泌治疗。观察两组患者治疗前后血清前列腺特异抗原（PsA）、剩余尿量、最大尿流率、国际前列腺症状评分（IPSS）及5年生存率。结果：术后3个月，TURP＋内分泌治疗组血PSA、剩余尿量及IPSS分别由术前的（35．7±12．1）ng／ml、（145．0±65．8）ml、（21．4±5．1）分降至（4．9±1．9）ng／ml、（27．0±15．2）ml、（8．7±2．6）分（P〈0．05），最大尿流率由（4．3±1．6）ml／S增至（11．7±3．7）ml／s（P〈0．05）；治疗12个月后差异仍有显著性（P〈0．05）。单纯内分泌组术后3个月血PSA由（31．4±10．7）ng／ml降至（5．6±2．2）ng／ml，两组比较，血PSA差异无统计学意义；剩余尿量、最大尿流率及IPSS差异均有统计学意义（P〈0．05）。内分泌组5年生存率为50％，TURP＋内分泌组为51．5％，总体生存率差异两组无统计学意义（P=0．919）。结论：TURP＋内分泌治疗能够显著缓解晚期前列腺癌患者膀胱出口梗阻症状，提高患者生活质量，且不影响生存率，是一种安全有效的治疗方式。

Transurethral resection of prostate for treatment bladder outlet obstruction induced by advanced prostatic cancer

Objective：To evaluate therapeutic efficacy and safety of transurethral resection of prostate（TURP） combined with endocrine therapy in patients with bladder outlet obstruction induced by advanced prostatic cancer. Methods：A total of 32 patients with advanced prostatic cancer participated in this study. 13 patients underwent en- docrine therapy only, and 19 underwent TURP combined with endocrine therapy. Prostate specific antigen（PSA） level, residue urine, maximum urine flow rate and international prostate symptom score（IPSS） were examined be fore and after treatment, and 5-year overall survival rates were explored. Results： 3 months after treatment, PSA, residue urine and IPSSdecreased from （35.7±12.1） to （4.9±1.9）ng/ml, （145.0±65.8） to （27.0±15.2）ml and （21.±5.1） to （8.7±2.6） respectively in TURP＋endocrine group（P〈0.05）, and the maximum flow rate increased from （4.3±1.6） to （11. 7±3.7）ml/s（P〈0.05）. 12 months after treatment, the rusults remain the same. In endocrine group, PSA decreased from （31.4±10.7） to （5.6±4-2.2）ng/ml 3 months after treatment. Between the two groups, PSA had no significant differences, whereas the residue urine, maximum urine flow rate and IPSS had statistical significant 3 months after treatment （P〈0.05）. The 5-year overall survival rates of pa tients were 50% in endocrine group and 51.5% in TURP＋ endocrine group respectively, and no significant differ ence was found between the two group（P=0. 919）. Conclusions： TURP combined with endocrine therapy can re lieve the bladder outlet obstruction symptoms in patients with advanced prostatic cancer, and improve the quality of the patients＇ life. There was no negative impact of TURP on survival, and it is a fairly safe and effective proce- dure.