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目的探讨经尿道前列腺电切术联合雄激素阻断治疗前列腺癌的临床疗效。方法回顾性分析2002年11月~2005年8月29例前列腺癌病例,其中3例为入院前8~36个月就确诊为前列腺癌并已作了睾丸切除术的患者,3例以前列腺增生为诊断收入院,余23例前列腺癌为诊断入院。所有病人均因排尿不畅而行经尿道前列腺电切术,并同时用手术或药物去势及雄激素阻断治疗。结果随访2~33个月,3例睾丸切除后复发的病人,加用药物雄激素阻断治疗,病情不能控制,其中2例分别于术后4个月及9个月因肿瘤扩散死亡;1例前列腺特异性抗原(PSA)仍缓慢上升。18例加手术去势者中,16例PSA均保持在正常范围,2例PSA已回升超过正常范围。8例药物去势(雄激素全阻断间歇治疗)者,PSA仍控制在允许范围内,病情稳定。26例排尿均通畅,1例排尿困难带膀胱造瘘管。结论经尿道前列腺电切术加雄激素阻断治疗适用于各期前列腺癌,联用间歇性药物雄激素全阻断有更好临床应用价值。
Objective To investigate the clinical efficacy of transurethral resection of prostate combined with androgen blockade in the treatment of prostate cancer. Methods A retrospective analysis of 29 cases of prostate cancer from November 2002 to August 2005 were retrospectively analyzed. Among them, 3 cases were diagnosed as prostate cancer and had orchiectomy 8 to 36 months before admission, and 3 cases were diagnosed as benign prostatic hyperplasia For the diagnosis of income hospital, more than 23 cases of prostate cancer for diagnosis and admission. All patients due to poor urination and transurethral resection of prostate, and at the same time with surgery or drug castration and androgen blocking therapy. Results The patients were followed up for 2 to 33 months. Three patients who recurred after orchiectomy were treated with androgen blockade, and the disease could not be controlled. Two of them died of tumor spread at 4 and 9 months after surgery respectively. 1 Prostate-specific antigen (PSA) is still rising slowly. Of the 18 patients who underwent surgical castration, 16 of the PSA remained in the normal range and 2 of the PSA had been recovered beyond the normal range. 8 cases of drug castration (androgen blockade intermittent treatment), PSA is still controlled within the allowable range, stable condition. 26 cases of urination were smooth, 1 case of dysuria with bladder fistula. Conclusions Transurethral resection of prostate and androgen blockade is suitable for all stages of prostate cancer. Combined with intermittent drug androgen blockade, it has better clinical value.