电化学治疗前列腺增生动物及体外实验与临床观察

Experimental Study and Clinical Application of Transurethral Electrochemical Therapy on Benign Prostatic Hyperplasia.

目的探讨电化学治疗良性前列腺增生的安全性及临床疗效,方法自2002年5月～2004年5月,应用电化学前列腺增生治疗仪(EASY-100)对实验犬前列腺及邻近器官影响,人离体前列腺组织体外实验组织学观察,临床治疗前列腺增生35例,通过国际前列腺症状评分(I-PSS),生活质量评分(QOL),最大尿流率(Qmax.),残余尿(PVR),前列腺体积(V)夜尿次数等主要指标观察。结果选择合适长度的电极对犬前列腺尿道具有直接损伤作用,超长电极及可发生尿失禁及尿道直肠瘘,体外实验显示,经尿道电化学治疗可使尿道周围6～9mm 范围内的前列腺组织发生不可逆的坏死变性。临床治疗35例,治疗前后 IPSS、QOL 有显著性差异(P<0.001),Qmax 有显著性差异(P<0.005),残余尿及效尿次数明显减少(P<0.001),治疗前后体积无明显变化(P>0.05),总有效率91%。结论经尿道电化学治疗前列腺增生操作简单,无需麻醉,耐受性好,安全有效,尤其适合不能耐受手术的前列腺增生患者。

Objective To study the safety and efficiency of nsurethralelectrochemical therapy (ECT) on benign prostatic hyperlasia. (BPH).Methods From May.2002 to May.2004,An experimental electrechomical therapy on prostate has been carred out in 8 dogs and ECT was used on prostate specimens obstained on suprapubic prostatectomy.On the basis of the experiment,ECT was then carried out for 35 patients suffered from BPH.The relevant parameters were assessed.Results In the experimental group,good therapeutic effect was achieved if the elec- trode was 5mm shorter than the prostatic urethra.On the other hand if the electrode was 5mm longer than the prostatic urethera,urethro-rectal fistula andurine incontinence might result.In the prostate specimens obtained on suprapubic prostatectomy group,irreversible patho logical changes occurred and increased with the accumulation of therapeutic power.In the clinieal group,the effective rate 91% with no complieation ob- served.The was significant difference of IPSS,QOL,Qmax,PVR.before and after treatment but not so V.Conclusions Transurethral electro- chemical treatment wae beleieved to be simple safe,efective and well-tolerable especialy for the high risk patients.