3D DSA引导下前列腺动脉栓塞治疗良性前列腺增生

3D DSA-guided prostatic arterial embolization in treatment of benign prostatic hyperplasia

目的观察3D DSA引导下前列腺动脉栓塞(PAE)治疗良性前列腺增生(BPH)的效果。方法回顾性分析70例接受DSA引导下PAE的BPH伴中、重度下尿路症状(LUTS)患者,其中接受3D DSA(3D组)及2D DSA(2D组)引导下PAE各35例。对比分析2组治疗相关资料、治疗效果及并发症发生情况。结果2组均成功完成PAE。3D组左、右侧插管时间及操作时间、辐射时间、辐射剂量、剂量面积乘积(DAP)、总造影次数和造影图像帧数均小于2D组(P均<0.05)。术后2组均有发热、疼痛、泌尿系感染等轻微并发症发生,均未见严重并发症,组间差异无统计学意义(P>0.05)。术后6个月,70例前列腺体积、国际前列腺症状评分(IPSS)、生活质量指数(QOL)评分均较术前减小(P均<0.05),组间差异无统计学意义(P均>0.05)。结论3D DSA引导下PAE治疗BPH伴中、重度LUTS安全、有效,且能减少造影次数,缩短治疗及插管时间,降低辐射剂量。

Objective To observe the effect of 3D DSA-guided prostatic arterial embolization(PAE)for treating benign prostatic hyperplasia(BPH).Methods Data of 70 BPH patients with moderate or severe lower urinary tract symptoms(LUTS)who underwent 3D(3D group,n=35)or 2D(2D group,n=35)DSA guided PAE were retrospectively analyzed.The operational indexes,therapeutic effects and complications were observed and compared between groups.Results PAE was successfully performed in all 70 cases.The left and right side intubation time,operation time,radiation time,radiation dose,dose area product(DAP),total times of angiography and number of angiography frames in 3D group were all less than those in 2D group(all P<0.05).Six months after PAE,prostate volume,international prostate symptom score(IPSS)and quality of life(QOL)scores decreased in both groups compared with pre-operation(all P<0.05),and there was no statistical significance between groups(all P>0.05).Postoperative complications such as fever,pain and urinary tract infection were observed in both groups without significant difference(P>0.05),while no serious complication occurred.Conclusion 3D DSA-guided PAE was safe and effective for treatment of BPH with moderate and severe LUTS,which could effectively reduce the times of angiography,shorten the operation time and intubation time and reduce intraoperative radiation dose.