前列腺动脉栓塞治疗良性前列腺增生的中期疗效分析

Mid-term efficacy of prostatic artery embolization for benign prostatic hyperplasia

目的探讨前列腺动脉栓塞(PAE)治疗良性前列腺增生源性下尿路梗阻症状(LUTS)、尿潴留及血尿的中期疗效。方法回顾性分析2014年2月至2018年12月在我院确诊为良性前列腺增生并接受PAE治疗的140例患者的临床资料,其中LUTS患者85例(60例单纯LUTS+25例LUTS合并血尿),尿潴留患者52例(50例单纯尿潴留+2例尿潴留合并血尿),单纯肉眼血尿患者3例,随访24个月并评价PAE临床成功率。采用Friedman检验比较PAE术前及术后各随访时间点国际前列腺症状评分(IPSS)、生活质量(QoL)评分及前列腺体积(PV)的差异,2个特定时间点各指标两两比较采用Bonferroni方法。结果85例LUTS患者术前及术后3、6、12、24个月的IPSS、QoL评分及PV两两比较,差异均存在统计学意义(P<0.001),术后各随访时间点临床成功率分别为95.3%(81/85)、91.8%(78/85)、87.1%(74/85)、83.5%(71/85)。52例尿潴留患者术后30 d内尿管拔除率98.1%(51/52),平均拔管时间(6.8±3.7)d,术后临床成功率分别为94.1%(48/51)、92.2%(47/51)、88.2%(45/51)、84.3%(43/51)。血尿患者术后平均肉眼血尿消失时间(3.4±2.5)d,术后临床成功率分别为90.0%(27/30)、90.0%(27/30)、83.3%(25/30)、80.0%(24/30)。结论PAE治疗良性前列腺增生源性下尿路梗阻症状、尿潴留及血尿中期内均是有效的。

Objective To investigate the mid-term efficacy of prostatic artery embolization(PAE)for the treatment of lower urinary tract symptoms(LUTS),urinary retention(UR)or hematuria secondary to benign prostatic hyperplasia(BPH).Methods This was a retrospective study conducted from February 2014 to December 2018 in 140 patients who underwent PAE for LUTS,UR or hematuria secondary to BPH,including 85 patients with LUTS(60 patients with LUTS and 25 LUTS combined with hematuria),52 patients with UR(50 patients with UR and 2 UR combined with hematuria)and 3 patients with hematuria.All patients were followed up for 24 months.Clinical success rates were evaluated.Friedman test was performed to compare the differences in International Prostate Symptom Score(IPSS),quality of life(QoL)score,and prostatic volume(PV)between baseline and follow-up time points(3,6,12 and 24 months).A post hoc test was performed by the Bonferroni method.Results Significant differences in IPSS,QoL score and PV between baseline and follow-up time points were observed in 85 patients with LUTS(P<0.001 for all),and clinical success rates at 3,6,12,24 months after PAE were 95.3%(81/85),91.8%(78/85),87.1%(74/85),83.5%(71/85).The success rate of extubation in patients with UR within 1 month after PAE was 98.1%(51/52).The average interval from PAE to catheter-independence was(6.8±3.7)days,and clinical success rates were 94.1%(48/51),92.2%(47/51),88.2%(45/51),84.3%(43/51),respectively.The interval from PAE to the resolution of hematuria was(3.4±2.5)days,and clinical success rates were 90.0%(27/30),90.0%(27/30),83.3%(25/30),80.0%(24/30),respectively.Conclusions PAE was an effective treatment option for symptoms secondary to BPH in mid-term follow up.