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目的探讨经尿道绿激光汽化术(PVP)联合间歇内分泌治疗局部晚期前列腺癌的临床疗效。方法对20例局部晚期前列腺癌患者应用(PVP)联合间歇内分泌治疗,PSA(11.3～647.2ng/ml);Gleason Score:7～9分;临床分期:T3N0M0。观察手术时间、术中出血量、手术并发症以及术前、术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、剩余尿量(RU)、最大尿流率(Qmax)、手术前后前列腺特异性抗原(PSA)的差异。术后雄激素全阻断治疗,当PSA:0ng/ml,并稳定2个月后停止内分泌治疗。当PSA连续三次上升则重新开始内分泌治疗。结果手术时间30～50(34.3±9.7)min;术中出血量20～55(26.3±15.2)ml,术后患者全部随访3～30个月,19例患者未发现血行转移或骨转移,20例排尿通畅,1例术后17个月死亡。IPSS评分由(25.1±4.7)分下降至(8.2±2.8)分,QOL由(4.5±0.8)分下降至(2.5±0.6)分,RU由(80.3±21.3)分减少至(26.8±12.3)ml,Qmax由(7.2±5.0)ml/s上升至(17.2±5.0)ml/s,PSA(11.3～647.2ng/ml)术后降至(0～0.5ng/ml),手术前后各参数比较具有统计学意义(P<0.05)。结论绿激光汽化术联合间歇内分泌治疗局部晚期前列腺癌临床疗效肯定,可作为治疗局部晚期Pca及改善患者生存质量的治疗措施之一。
Objective To investigate the clinical efficacy of transurethral vaporization of green laser (PVP) combined with intermittent endocrine in the treatment of locally advanced prostate cancer. Methods 20 patients with locally advanced prostate cancer were treated with intermittent endocrine therapy (PSA (11.3 ~ 647.2ng / ml), Gleason Score: 7-9, clinical stage T3N0M0. The operation time, intraoperative blood loss, operative complications, preoperative and postoperative IPSS scores, QOL, RU, Qmax, Differences in prostate-specific antigen (PSA). Postoperative androgen blockade treatment, when PSA: 0ng / ml, and stable for 2 months after the endocrine therapy. When the PSA rises three times in a row, the endocrine therapy is restarted. Results The operation time was 30-50 (34.3 ± 9.7) min. The intraoperative blood loss was 20-55 (26.3 ± 15.2) ml. All the patients were followed up for 3-30 months. No blood metastasis or bone metastasis was found in 19 patients. Cases of voiding patency, 1 patient died after 17 months. IPSS decreased from (25.1 ± 4.7) points to (8.2 ± 2.8) points, QOL decreased from (4.5 ± 0.8) points to (2.5 ± 0.6) points, and RU decreased from (80.3 ± 21.3) points to (26.8 ± 12.3) ml, Qmax increased from (7.2 ± 5.0) ml / s to (17.2 ± 5.0) ml / s, PSA decreased from (11.3 ~ 647.2 ng / ml) to Statistically significant (P <0.05). Conclusion Green laser vaporization combined with intermittent endocrine treatment of locally advanced prostate cancer clinical efficacy of positive, as the treatment of locally advanced Pca and improve the quality of life of patients with one of the measures.