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目的评价梗阻性前列腺癌病人放置可回收自膨式带倒钩金属支架的技术可行性和临床疗效。方法带8个倒钩的可回收自膨式金属支架连续置入8例梗阻性前列腺癌病人体内。病人年龄55~76岁(平均69岁)。8例病人先前都接受过激素治疗,其中3例病人曾行姑息性经尿道前列腺切除术。出现并发症时这些支架通过一个21F支架移除装置回收。结果所有支架均成功置入,而且所有病人都能耐受。其中1例严重尿失禁自然好转,另有2例病人的肉眼血尿在4d后自然消失。支架植入1个月后病人最大尿流率和膀胱残余尿量分别是5.6~10.2mL/s(平均:8.3mL/s)和5~45mL(平均:27mL)。经过平均约192d(39~632d)的随访,1例病人在232d后因支架内结石形成需要移除支架。由于支架移除后肿块好转而不需要进一步介入治疗。结论初步结果表明带8个倒钩的可回收自膨式金属支架在梗阻性前列腺癌病人中的应用具有可行性和有效性。要点①可回收金属尿道支架对梗阻性前列腺癌病人有帮助。②带8个倒钩的可回收自膨式支架是可行的、有效的。③这些支架显然解决了支架移动的问题。④移去这些支架是安全的,不需要外科手术,局部麻醉即可。
Objective To evaluate the technical feasibility and clinical efficacy of recoverable self-expanding barbed metal stent in patients with obstructive prostate cancer. Methods Eight barbwire recoverable self-expandable metal stents were continuously placed in 8 patients with obstructive prostate cancer. Patients aged 55 to 76 years (mean 69 years). Eight patients had previously received hormone therapy, and three of the patients had palliative transurethral resection of the prostate. These stents are recovered via a 21F stent removal device in the event of complications. Results All stents were successfully inserted and tolerated by all patients. One case of severe urinary incontinence naturally improved, while the other two patients with gross hematuria disappeared after 4d. One month after stent implantation, the maximum urinary flow rate and bladder residual urine volume were 5.6-10.2 mL / s (average: 8.3 mL / s) and 5-45 mL (mean: 27 mL), respectively. After an average of about 192d (39 ~ 632d) of follow-up, 1 patient after 232d due to stent stone formation need to remove the stent. As the tumor removed after the stent improved without the need for further intervention. Conclusions The preliminary results show that the use of eight barbed retractable self-expanding metal stents in patients with obstructive prostate cancer is feasible and effective. Key points ① recoverable metal urethral stent in patients with obstructive prostate cancer helpful. ② with eight barbs retractable self-expanding stent is feasible and effective. ③ These brackets clearly solve the problem of stent movement. ④ remove the stent is safe, do not need surgery, local anesthesia can be.