前列腺癌患者^(125)I近距离放射治疗后发生急性尿潴留的多因素分析

Multiplicity of acute urinary retention following ^(125)I prostate brachytherapy

目的分析125I治疗前列腺癌(Brachytherapy)后发生急性尿潴留的各种因素,提出预见性因素,为临床评估及干预提供依据,改进125I植入方法,减少急性尿潴留并发症的发生率。方法我院2008年7月～2011年3月,126例前列腺癌患者行经直肠125I粒子植入,对于发生急性尿潴留的患者,从临床相关,治疗相关两大因素进行综合分析。结果126例125I植入的前列腺癌患者中15例发生了急性尿潴留,均行保留导尿。发生急性尿潴留的时间中位数为植入粒子的第2d(1～7d),保留导尿的时间中位数为7d(4～10d)。单变量分析临床相关,治疗相关因素,再行多因素综合分析,发现穿刺进针数(Number of needles),125I植入前IPSS评分(pre-implant IPSS),植入前前列腺B超体积(pre-implant US prostatevolume),植入125I的粒子数量(number of seeds)与急性尿潴留之间是有统计学意义的(P<0.05),多因素分析number ofneedles,pre-implant IPSS最有意义(P<0.01)。结论 number of needles及pre-implant IPSS可以做为125I近距离放射治疗前列腺癌患者是否发生急性尿潴留的可预见性因素。

Objective To analyze various fctors of acute urinary retention following 125^I prostate brachytherapy and to raise predictive factors.thus,we can provide evidence for clinical assessment and clinical interference.we also can improve implantation method of 125^I brachytherapy to reduce incidence of acute urinary retention.Methods A group of 126 consecutive patients with prostate clinical,treatment-related were evaluated for the need for catheterization owing to urinary retention.Results Fifteen patients（12%） required catheterization.The median time to onset was 2 days after implantation（range 1～7 days）.The median duration of catheterization for urinary retention was 7 days（range 4～10 days）.Univariate analysis demonstrated that number of needles,pre-implant IPSS,pre-implant US prostate volume and number of seeds were predictive for catheterization.In multivariate analysis,number of needles and pre-implant IPSS were significant indendent priditive factors for catheterization.Conclusion Our data suggest that the number of needles and pre-implant IPSS might be the strongest predictors for catheterization.