不同粒径PVA颗粒在介入栓塞治疗高龄高危良性前列腺增生中的应用

Application of Different Particle Size PVA Particles in Interventional Embolization for Advanced High-risk Benign Prostatic Hyperplasia

目的探讨介入栓塞治疗高龄高危良性前列腺增生(BPH)采用不同粒径PVA颗粒的临床疗效和影响。方法回顾性分析2016年6月-2018年8月间该院收治的因BPH经内科保守治疗无效,无法或难以接受外科手术并愿意行前列腺动脉栓塞(PAE)治疗的高龄高危患者24例。PAE中使用直径为150~350μm、350~560μm PVA颗粒者各12例,分别归入A组和B组,观察两组患者术前和术后1月和6月国际前列腺症状评分(IPSS)、生活质量评分(QOL)、前列腺体积(PV)、最大尿流率(Qmax)、残余尿量(PVR)的变化和术后并发症等情况。结果 PAE后两组患者IPSS、QOL、PV、Qmax和PVR与术前比较差异有统计学意义(P<0.05),A、B两组患者对比分析,术后IPSS、QOL评分和PV差异有统计学意义(P<0.05),而Qmax和PVR差异无统计学意义(P>0.05)。B组患者术后并发症发生率25.0%优于A组41.6%,但差异无统计学意义(χ^2=0.75,P=0.386),且B组持续时间(62.1±12.6)h,明显短于A组(82.6±14.3)h,两组比较差异有统计学意义(t=10.126,P<0.05)。结论 PAE治疗高龄高危BPH是一种安全、有效和可行的方法;不同粒径PVA颗粒的选择在IPSS、QOL评分和PV方面对临床疗效有影响,而在Qmax和PVR方面无影响。

Objective To investigate the clinical efficacy and influence of interventional embolization for the treatment of high-risk benign prostatic hyperplasia(BPH) with different particle size PVA particles. Methods A retrospective analysis of24 high-risk patients admitted to the hospital from June 2016 to August 2018 due to conservative treatment of BPH was not effective or difficult to undergo surgery and was willing to undergo prostate artery embolization(PAE). In PAE, 12 patients with diameters of 150-350 μm and 350-560 μm PVA were included in group A and group B. The international prostate symptom scores(IPSS) were observed before and 1 month and 6 months after surgery. Quality of life score(QOL), prostate volume(PV), maximum urinary flow rate(Qmax), changes in residual urine volume(PVR), and postoperative complications.Results The differences of IPSS, QOL, PV, Qmax and PVR between the two groups after PAE were statistically significant(P<0.05). The comparison between the two groups of A and B, the postoperative IPSS, QOL score and PV difference had statistical significance(P<0.05), and the difference between Qmax and PVR was not statistically significant(P>0.05). The incidence of postoperative complications in the B group 25.0% was better than in the A group(41.6%), but the difference was not statistically significant(χ^2=0.75, P=0.386). The duration of group B(62.1±12.6) h was significantly shorter than that of group A(82.6±14.3) h. The difference between the two groups was statistically significant(t=10.126, P<0.05). Conclusion PAE is a safe, effective and feasible method for the treatment of high-risk BPH. The selection of PVA particles with different particle size has an effect on clinical efficacy in terms of IPSS, QOL score and PV, but no effect on Qmax and PVR.