直肠超声引导注射聚桂醇治疗老年良性前列腺增生的初步研究

Preliminary study of transrectal ultrasound-guided lauromacrogol injection for treating benign prostate hyperplasia in elderly patients

目的观察经直肠超声引导注射聚桂醇治疗合并下尿路梗阻症状的老年良性前列腺增生的疗效。方法直肠超声引导下对42例合并下尿路梗阻症状的老年良性前列腺增生患者行前列腺内注射聚桂醇硬化治疗，治疗后1、3、6、12个月随访，观察治疗前后前列腺内腺体积变化、国际前列腺疾患排尿症状评分（IPSS）、残余尿量（PVR）及最大尿流率（Qmax），观察治疗前后超声造影表现，分析其并发症。结果治疗前患者的前列腺内腺体积、IPSS、PVR分别为（57．3±17．7）ml、（28．3±5．2）分、（143．8±82．5）ml，治疗后12个月分别减小到（44．8±6．1）ml、（8．8±1．4）分、（28．9±9．5）ml，与治疗前比较差异均具有统计学意义（P〈O．05），Qmax由治疗前（5．9±3．2）ml／s提高到（14．9±3．1）ml／s（P〈0．05），超声造影显示前列腺内腺出现充盈缺失，未出现明显并发症。结论经直肠超声引导下注射聚桂醇治疗前列腺增生具有微创、安全、有效、经济的特点，适用于不能或不愿接受手术治疗的老年患者。

Objective To observe the preliminary curative effect of transrectal ultrasound-guided lauromacrogol injection for treating benign prostate hyperplasia in elderly patients. Methods Forty-two patients with benign prostate hyperplasia combined with lower urinary tract symptonms received transrectal ultrasound-guided [auromacrogol injection. Then they were followed up after 3,6,12 months respectively. Prostate volume changes before and after treatment,international prostate symptom score（IPSS）, postvoid residual volume （PRV）, maximum urinary flow rate （Qmax） and features of contrast-enhanced ultrasonography before and after treatment were observed. Complications were analyzed. Results Before treatment,prostate volume,IPSS,PVR of patients were （57.3 ±17.7）ml, （28.3 ± 5.2）points, （143.8± 82.5） ml respectively,12 months after treatment,they reduced to （44.8 ±6.1）ml, （8.8 ± 1.4） points, （28.9 ± 9.5） ml,there were statistical diffrences between before and after treatment（ P〈0.05）. Qmax increased from （5.9± 3.2）ml/s to （14.9 ± 3.1）ml/s （P 〈0.05）. Contrast^enhanced ultrasonography showed filling defect sign in prostatic inner gland. No serve complications occurred. Conclusions Transrectal ultrasound-guided lauromacrogol injection for treating benign prostate hyperplasia has the characteristics of minimally invasive,safe,effective and economical. It applies to elderly patients who are unable or unwilling to have surgery.