前列腺动脉栓塞术治疗前列腺源性血尿临床效果

Prostatic artery embolization for the treatment prostate-derived hematuria:analysis of its curative effect

目的评价前列腺动脉栓塞术(PAE)治疗前列腺源性血尿的临床效果。方法回顾性分析2016年6月至2019年8月在福建省立医院因前列腺源性血尿接受PAE治疗的21例患者临床资料、造影表现及治疗效果。PAE技术成功的定义为双侧超选择插管并栓塞前列腺动脉。止血成功定义为PAE即刻止血或术后72 h内不需进一步干预情况下血尿控制。结果PAE术后21例患者中4例DSA造影可见对比剂外渗或小动脉瘤形成。2例良性前列腺增生患者一侧前列腺动脉迂曲严重,微导管无法超选进入,其余患者均成功实施双侧超选前列腺动脉栓塞,技术成功率为90.5%(19/21);20例止血成功,肉眼血尿在24 h内消失,止血率为95.2%(20/21),1例前列腺增生患者术后3 d仍有活动性肉眼血尿,转入外科手术。结论PAE治疗前列腺源性血尿微创、有效,值得临床推广应用。

Objective To evaluate the clinical efficacy of prostatic artery embolization(PAE)for the treatment of prostate-derived hematuria.Methods The clinical materials,imaging findings and therapeutic outcomes of 21 patients with prostate-derived hematuria,who were admitted to the Fujian Provincial Hospital of China to receive PAE treatment between June 2016 and August 2019,were retrospectively analyzed.Technical success was defined as the achievement of superselective catheterization and embolization of bilateral prostatic arteries.Clinical hemostasis success was defined as the achievement of hemostasis immediately after PAE or the achievement of control of hematuria with no need of further intervention within72 h after PAE.Results After PAE,extravasation of contrast medium or tiny pseudoaneurysm formation was demonstrated on DSA in 4 patients.Seriously tortuous prostate artery on one side were observed in 2 patients with benign prostatic hyperplasia(BPH),which rendered the microcatheter unable to be inserted into the prostate artery.Successful bilateral superselective PAE was accomplished in the remaining 19 patients.The total technical success rate was 90.5%(19/21).Successful hemostasis was obtained in 20 patients,their gross hematuria disappeared within 24 hours after PAE,the hemostasis rate was 95.2%(20/21).In one patient with BPH,active gross hematuria still existed 3 days after PAE,and the patient had to be transferred to surgery.Conclusion For the treatment of prostate-derived hematuria,PAE is mini-invasive and effective,therefore,this therapy is worth popularizing in clinical application.