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目的观察经尿道铥激光前列腺切除术联合雄激素全阻断治疗晚期前列腺癌合并膀胱出口梗阻的临床疗效。方法选择2010年8月-2012年4月在同济大学附属第十人民医院行铥激光前列腺切除术联合雄激素全阻断治疗的晚期前列腺癌患者,观察患者手术前、后总前列腺特异性抗原(tPSA),最大尿流率(MFR),残余尿(RV),国际前列腺症状评分(IPSS)和生活质量评分(QOL)的变化或进展情况。结果术后1、6、12个月,患者的tPSA水平、IPSS评分、QOL评分及RV均较术前显著降低(P值均<0.05),MFR较术前显著增高(P<0.05)。术后12个月,患者的tPSA水平显著高于术后6个月(P<0.05),RV显著高于术后1、6个月(P<0.05)。6例骨转移患者在随访期间均未出现新转移灶。1例患者随访至6个月,骨扫描提示T4椎体转移。结论 经尿道铥激光前列腺切除术联合雄激素全阻断治疗晚期前列腺癌合并膀胱出口梗阻简捷、安全、有效,是晚期前列腺癌姑息性治疗的一种重要方法。
Objective To observe the clinical effects of transurethral resection of laser prostatectomy combined with androgen blockade in the treatment of advanced prostate cancer with bladder outlet obstruction. Methods Select August 2010 - April 2012 at the Tenth People’s Hospital of Tongji University, 铥 铥 laser prostatectomy combined with androgen blockade of advanced prostate cancer patients observed before and after surgery in patients with total prostate-specific antigen ( tPSA, MFR, RV, IPSS, and quality of life (QOL). Results At 1, 6 and 12 months after operation, the tPSA, IPSS, QOL and RV in patients were significantly lower than those before operation (all P <0.05). The MFR was significantly higher than that before operation (P <0.05). At 12 months after operation, the tPSA level in patients was significantly higher than that of 6 months after operation (P <0.05), and RV was significantly higher than that of 6 months after operation (P <0.05). Six cases of bone metastases did not show any new metastases during follow-up. One patient was followed up for 6 months. Bone scan showed T4 vertebral body metastasis. Conclusions Transurethral 铥 laser prostatectomy combined with androgen blockade in the treatment of advanced prostate cancer combined with bladder outlet obstruction is simple, safe and effective and is an important method for palliative treatment of advanced prostate cancer.