经会阴射频多极针消融术治疗前列腺增生症和前列腺癌

TRANSPERINEUM RF MULTI-HOOK PROBE INTERSTITIAL ABLATION FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA (BPH) AND PROSTATIC CANCER (PC)

目的 :建立使用“射频多极针”经会阴进路行前列腺组织消融治疗前列腺癌和前列腺增生症的方法 ,验证临床效果。方法 :对前列腺癌 (7例 )和前列腺增生症 (2 8例 )病人在CT或直肠B超的引导下 ,采用射频多极针经会阴进路行前列腺组织消融术 ,并对术前术后IPSS评分 ,生活质素评分QoL ,J最大尿流率MFR ,前列腺容积VP和残余尿RU进行比较。结果 :30例定期坚持随访复查 ,5例电话随访。 30例中 ,前列腺增生症 2 3例 ,前列腺癌 7例 ,术后随访时间分别在 2 ,3和 6月。IPSS积分BPH病人从术前 2 6 .5 8± 5 .0 0 ,2个月后降至9.11± 6 .0 8,PC病人从 16 .11± 3.2 1降至 2 .2 0± 0 .4 6 ,P <0 .0 0 1;BPH病人QoL从 4 .11± 1.2 1降至 2 .4 0±0 .91,PC病人 ,从 4 .0 8± 0 .97降至 2 .2 0± 0 .4 6 ,P <0 .0 0 1;BPH病人MFR从 5 .91± 3.5 6ml/s提高至 12 .8± 4 .12ml/s,PC病人从 14 .6± 4 .0 8ml/s升至 14 .6± 4 .0 8ml/s ,P <0 .0 0 1;BPH病人残余尿RU从 14 8± 6 6 .9ml降至 17.9± 9.90ml,PC病人从 85 .7± 4 0 .6 8ml降至 8.97± 3.18ml,P <0 .0 0 1;BPH病人前列腺体积VP从 4 9.4± 2 4 .9ml缩减至 4 2 .8± 12 .7ml,PC病人从 6 8.2 4± 2 5 .4ml缩减至 4 0 .1± 8.34ml,P <0 .0 5。PSA也有不同程度的下降 ,

Objective:To establish a new method with multi-hook probe interstitial ablation via Transperineum access for the treatment of BPH and PC and evaluate the clinical effect.Method:From Apr., 2000 to Apr., 2001,28 patients with BPH and 7 patients with PC were treated with a special RF multi-hook probe inserted to prostatic gland via Perineum under ultrasound or CT guides, 2～3 ablation each side of prostatic gland were created for 5 mini/each and comparing IPSS, QOL, MFR, VP, RU of pretreatment with them of 2,3 and 6 month post- treatment.Results:Thirty patients of 35 patients (23 patients with BPH, 7 patients with PC) have been followed up at appointed time six month after the treatment.I-PSS decreased from 26.58～5 to 9.11～6.08 in BPH, from 16.11±3.21 to 2.20±0.46 in PC( P <0.001); QoL decreased from 4.11±1.21 to 2.40±0.91 in BPH, from 4.08±0.97 to 2.20±0.46 in PC; MFR increased from 5.91 ±3. 56ml/s to 12.8±4.12ml/s in BPH,from 4.6±4.08ml/s to 14.6±4.08ml/s in PC, P <0.001; RU decreased from 148±66.9ml to 17.9±9.90ml in BPH,from 85.7±40.68ml to 8.97±3.18ml in PC;VP decreased from 49.4±24.9ml to 42.8±12.7ml in BPH, from 68.24±25.4ml to 40.1±8.34ml, P <0.05;PSA decreased in some degree after 6 months of treatment. Obvious improvements, both subjectively and objectively, were observed after this treatment.Conclusion:The study shows that Transperineum multi-hook probe interstitial ablation is an effective and safe new treatment for BPH and PC.