经直肠超声引导穿刺注射无水乙醇治疗良性前列腺增生的价值

Injection of dehydrated alcohol with transrectal ultrasound-guided puncture in treatment of benign prostatic hyperplasia

目的探讨经直肠超声引导注射无水乙醇治疗良性前列腺增生症所致持续性尿道梗阻的价值。方法经直肠超声引导对28例因前列腺增生引起尿道梗阻患者行局部注射无水乙醇消融治疗，术后2周、1个月、6个月随访。结果术后6个月，前列腺体积从（54．17±19．32）cm^3下降到（46．47±14．45）cm^3，25例患者术后7～37d（平均12．8d）拔除导尿管或膀胱造瘘管后能够自主排尿；无水乙醇1次注射量4．0～10．0ml（平均6．6ml）；国际前列腺症状评分由术前（19．89±7．44）分降至（2．35±1．42）分；国际前列腺疾患排尿症状对生活质量评估由术前（4．14±1．21）分下降至（2．35±1．42）分，术中、术后无严重并发症。结论经直肠超声引导穿刺注射无水乙醇简单易行，并发症少，尤其适用于不耐受手术及麻醉前列腺增生高龄患者。

Objective To explore the value of injection of dehydrated alcohol with transrectal ultrasound - guided puncture in treatment of patients with persistent urinary retention resulting from benign prostatic hyperplasia （BPH）. Methods Injection of dehydrated alcohol ablation treatment with transrectal ultrasound guidance were applied on 28 patients with persistent urinary retention caused by BPH, the patients were followed up on 2 weeks, one month and six months after operation. Results Six months after operation,the prostate volume were decreased from （54.17 ± 19.32）cm^3 to （46.47 ± 14.45）cm^3, 7 d to 37 d （mean 12.8 d） after injection of dehydrated alcohol with 4 ml to 10 mL （mean 6.6 ml）, spontaneous micturition occurred in 25 patients after urethral catheter removal. International prostate symptom scores （IPSS）decreased from （19.89 ± 7.44） to （2.35 ± 1.42）. Quality of life scores （QOL） decreased from （4.14 ± 1.21） to （2.35 ± 1.42）. No serious complications happened during or after operation. Conclusion It is a safe and simple method in treatment of BPH. There are few intraoperative and postoperative complications, especially for old patients with intolerance to operation and anesthesia.