支架治疗老龄高危前列腺增生症疗效评估

ASSESSMENT FOR TREATING ELDERLY HIGH BENIGN PROSTATE HYPERPLASIA WITH STENT

探讨镍钛记忆合金网状支架 (支架 )治疗老龄高危前列腺增生症 (BPH)近远期疗效。方法 :选择此类BPH 13例。定期检测支架治疗后膀胱残余尿量 (RUV)、急性尿潴留 (AUR)、最大尿流率 (MFR)和国际前列腺症状评分 (I -PSS) ,分别与支架治疗前所测以上数据比较。结果 :RUV、MFR和I-PSS均比支架治疗前有明显改善 ,但个体间各项数据波动范围较大。因移位取出支架 3例 ,支架腔内粘膜增生导致间歇性AUR3例。结论 :支架治疗BPH的近远期效果尚不稳定。支架应用于不宜手术、逼尿肌功能良好和生活期有限的老龄高危BPH病人较妥当。不同长度及口径的支架可减少植入后的移位 ,经尿道电切术可缓解支架腔内粘膜增生所致急性尿潴留。

Objective: To research the effect of recent and future period with stent for treating elderly high risk benign prostate hyperplasia (BPH). Methods: Thirteen patients suffered from BPH for study. Examining residual urine volume (RUV), maximum flow rate (MFR), acute urinary retention (ARU) and international prostatic synptatic score (I-PSS) at regular intervals after implanted prostatic stents were compared respectively with doing those before implantation. Results: Mean follow-up 44.6 months (39~57 months). RUV, AUR, MFR and I-PSS were all improved significantly than those before implantation. There was considerable variation at each time interval in individual RUV, MFR and I-PSS measurements and a poor correlation with them each other. Three stents had to be removed because of stent migration. The development of epithelial hyperplasia within the lumen of the stent resulted in AUR in three patients at intervals. Conclusions: The effect of recent and future period with stent for BPH is considered instable. It is suitable to treat unfit for an operation, elderly high risk and detrusor stability BPH stents with variation at length and diameter can reduce the migration of stent following implanted stent, Catheterization, oral 'Tamsulosin', or being reseted endoscopically can alleviate AUR resulted from epithelial hyperplasia within lumen of stent.