经尿道等离子前列腺剜除术联合抗雄激素治疗中晚期局部前列腺癌伴膀胱出口梗阻的临床观察

Clinical observation of advanced transurethral plasmakinetic resection of the prostate combined with anti-androgen in the treatment of localized prostate cancer with bladder outlet obstruction

目的：探讨经尿道等离子前列腺剜除术联合抗雄激素治疗中晚期局部前列腺癌伴膀胱出口梗阻的有效性。方法：共计52名确诊前列腺癌且伴膀胱出口梗阻的患者,均行经尿道等离子前列腺剜除术后行双侧睾丸切除术加抗雄激素治疗（比卡鲁胺胶囊每日150mg）,从术后第8d开始给予比卡鲁胺胶囊50mg,口服,3次/d。观察比较患者手术前、后的PSA、IPSS、Qmax、残余尿量及生活质量评分的变化或进展情况。结果：术后随访12个月-3年52名患者的PSA、IPSS、Qmax、残余尿量及生活质量评分、客观缓解率获得明显改善。结论：经过上述方法治疗后的患者,能迅速、安全、有效地解除中晚期前列腺癌致膀胱出口梗阻,并可延缓疾病的进展,提高患者的生活质量。是安全有效的姑息性治疗的方法之一。

Objectives： To investigate the efficacy of advanced transurethral plasmakinetic resection of the prostate combined with anti- androgen in the treatment of localized prostate cancer with bladder outlet obstruction.Methods： The clinical data of 52 patients diagnosed as advanced prostatic cancer accompanied by bladder outlet obstruction,who were treated in our hospital by Plasma Kinetic Enucleation of Prostate and maximal antiandrogen blockade therapy（ Bicalutamide drug）,were retrospectively reviewed. The changes in total prostate specific antigen（ t PSA）,international prostate symptom score（ IPSS）,maximum urinary flow rate（ Qmax）,residual urine volume（ RV） and quality of life（ QOL） before and after the operation were observed. Results： t PSA,IPSS,QOL score and RV were significantly decreased before operation,and Qmax were significantly increased postoperatively.Conclusions： The treatment can quickly,safely,effectively relieve the advanced prostate cancer with bladder outlet obstruction,delay the progress of the disease and improve the quality of life of patients. This method is effective and safe in the treatment of palliative care.