经直肠针刺组织内消融治疗良性前列腺增生症临床报告

Transrectal interstitial ablation for the treatment of benign prostate hyperplasia

目的探讨一种安全、简便、疗效确切的良性前列腺增生症（Ｂｅｎｉｇｎｐｒｏｓｔａｔｅｈｙｐｅｒｐｌａｓｉａ，ＢＰＨ）非手术治疗方法。方法采用ＷＥ７５６６型前列腺组织内消融治疗仪及自行制作的消融针引导器，对２３例ＢＰＨ患者经直肠前列腺组织内针刺消融治疗（Ｔｒａｎｓｒｅｃｔａｌｉｎｔｅｒｓｔｉｔｉａｌａｂｌａｔｉｏｎ，ＴＲＩＡ）。据前列腺增生体积确定进针数，本组平均进９针，进针深度１５～２０ｃｍ，每针消融时间７ｍｉｎ，消融最高温度为９５℃。对２１例患者治疗后３个月、６个月分别进行了随访。结果残余尿、国际前列腺症状评分（Ｉ－ＰＳＳ）、生活质量评分（ＱＯＬ）分别与治疗前比较差异有极显著意义（Ｐ＜００１），最大尿流率（ＭＦＲ）及前列腺体积治疗后６个月改善显著（Ｐ＜００１）。

Objective To report the method and summarize the experience of transrectal interstitial ablation (TRIA) for the treatment of benign prostate hyperplasia (BPH). Methods 23 cases of benign prostate hyperplasia(BPH) were treated by using the WE 7 566 type transrectal interstitial ablation(TRIA) system and a home-made lead guide for ablation needle.According to the size of prostate hyperplasia the number of ablation puncture can be determined,which was 9 on an average(ranging 6 to 14).Each puncture was 1.52.0 cm in depth,lasted for 7 minutes,and the highest temperature in the prostatic tissue was 95 degrees centigrade.21 cases have been followed up for 3 months and 6 months. Results It was observed that there was significant improvement in residual volume of urine,international prostate symptom score (I-PSS) and quality of life(QOL)(P<0.01).Six months after treatment there was a significant difference in maximal urine flow rate(MFR) and volume of prostate (P<0.01). Conclusion It is concluded that transrectal meedle ablation therapy is a simple and easy proudure of high,safety and slight trauma,and recommendable as a new nonoperative method for treatment of BPH.