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目的探讨晚期前列腺癌并发症的治疗方法,以提高治疗水平。方法对26例老年晚期前列腺癌患者分别出现的骨痛、贫血、尿路梗阻、顽固性血尿及下肢和阴囊水肿等并发症分别予多种止痛剂(24例)、博宁(14例)、氯化锶(6例)、外放射(9例)、间断输血(9例)、经尿道前列腺电切术(7例)、耻骨上膀胱穿刺造瘘术(8例)、经皮肾盂穿刺造瘘术(4例)、经膀胱镜电灼止血(6例)及冲洗引流术(6例)等治疗。结果26例中,10例死亡,16例存活;博宁治疗的14例每次治疗疼痛缓解1～3个月;外放射治疗的9例疼痛缓解期4～6个月;89Sr治疗的6例每次治疗疼痛缓解约1个月;4例肾盂穿刺造瘘的患者维持4～14个月,血尿素氮及肌酐均无明显增高;接受经尿道前列腺电切术(TURP)治疗的7例排尿症状改善维持3～25个月;贫血的9例经间断输血后血红蛋白维持在90g/L以上;7例下肢水肿的患者治疗后症状部分缓解。结论骨痛、贫血、尿路梗阻、血尿及下肢水肿等是晚期前列腺癌常见的并发症,对患者的生存质量危害极大,应采取综合措施妥善处理。
Objective To explore the treatment of advanced prostate cancer complications in order to improve the treatment level. Methods Twenty-six cases of pain, anemia, urinary tract obstruction, intractable hematuria, and lower extremities and scrotal edema were respectively included in this study. Twenty-four cases of pain, 24 cases of Bonin, (6 cases), external radiotherapy (9 cases), intermittent blood transfusion (9 cases), transurethral resection of the prostate (7 cases), suprapubic bladder puncture (8 cases), percutaneous renal pelvis puncture Fistula (4 cases), transurethral electrosurgery (6 cases) and irrigation and drainage (6 cases) were treated. Results In 26 cases, 10 patients died and 16 patients survived. Pain relief was relieved in 14 patients treated with Bonin for 1 to 3 months. Pain relief in 9 patients treated with external radiation was 4 to 6 months. Six patients treated with 89Sr Pain was relieved in about one month in each treatment. Four patients with peritoneal puncture and fistula were maintained for 4 to 14 months without significant increase in blood urea nitrogen and creatinine. Urinary transurethral resection of the prostate (TURP) Symptoms were improved for 3 to 25 months; 9 cases of anemia were maintained above 90 g / L hemoglobin after intermittent blood transfusion; and 7 cases of lower extremity edema were partially relieved after treatment. Conclusion Bone pain, anemia, urinary tract obstruction, hematuria and lower extremity edema are common complication of advanced prostate cancer, and have great harm to the quality of life of the patients. Comprehensive measures should be taken to deal with them.