3种方法治疗前列腺增生症的效果比较

A CLINICAL REPORT OF THREE DIFFERENT THERAPIES FOR PROSTATIC HYPERPLASIA

①目的 比较α1 肾上腺素能受体阻滞类药物Terazosin、体外射频热疗法及耻骨上经膀胱前列腺切除术治疗前列腺增生症(BPH)的效果。②方法 30例BPH病人应用Terazosin 10 mg,每天1 次,用药3 个月;60例BPH病人给予体外射频热疗2 h,随访3个月;125例BPH病人行耻骨上经膀胱前列腺切除术,随访3个月。统计3种方法治疗前后症状评分、尿流率改善情况及并发症发生率。③结果 手术为最彻底解除下尿路梗阻手段,对临床症状及尿流率改善最优;Terazosin在缓解BPH症状上效果较为显著,几乎与手术相仿,但对尿流率改善较差;热疗法在缓解BPH症状及改善尿流率上皆差于手术,在症状缓解上亦差于Terazosin。④结论 手术仍为目前治疗BPH最有效手段,Terazosin及射频热疗法可以作为无手术指征病人或有绝对禁忌证病人的一种缓解症状的补充疗法。

Objective To compare the outcome of three kinds of therapy, Terazosin (α_1 adrenoceptor blocker), extracorporeal radiofrequency hyperthermia (ERH),and suprapubic prostatectomy, for benign prostatic hyperplasia(BPH). Methods Terazosin was applied to 30 BPH patients for three months; ERH to 60 BPH patients for two hours and followed up for three months; suprapubic prostatectomy was performed in 125 BPH patients, who were followed for three months. The symptom scores, urine flow rate and complications were recorded and compared before and after each treatment among the three groups. Results The open surgery was the most effective for BPH; Terazosin had remarkable effect on the improvement of the symptoms, with little effect on the rate of urine flow rate. The effect of extracorporeal radiofrequency was inferior to operation in the improvement of symptoms and urine flow; the effect of radiofrequency hyperthermia was inferior to Terazosin in terms of improvement of the symptoms. Conclusion The most effective treatment for BPH is operation, α_1 adrenergic receptor blocker and radiofrequency hyperthermia may be used for patients with no indications for surgery.