同期前列腺穿刺联合PVP对高龄、高危、可疑前列腺癌患者的疗效及安全性

doi:10.11958/20240564

天津医药 ›› 2024, Vol. 52 ›› Issue (9): 959-962.doi: 10.11958/20240564

同期前列腺穿刺联合PVP对高龄、高危、可疑前列腺癌患者的疗效及安全性

张志华(), 常泰浩, 罗飞, 王亚申, 李健^△()

天津市人民医院泌尿外科（邮编300121）

收稿日期:2024-05-08 修回日期:2024-06-28 出版日期:2024-09-15 发布日期:2024-09-06
通讯作者: ^△E-mail：lijian_umc@sina.com
作者简介:张志华（1977），男，副主任医师，主要从事前列腺疾病的基础与临床研究。E-mail：dzh_0204@163.com
基金资助:
天津市科技计划项目(22JCYBJC01500)

Efficacy and safety of simultaneous prostate biopsy combined with PVP in the treatment of elderly, high-risk and suspected prostate cancer patients

ZHANG Zhihua(), CHANG Taihao, LUO Fei, WANG Yashen, LI Jian^△()

Department of Urology, Tianjin Union Medical Center, Tianjin 300121, China

Received:2024-05-08 Revised:2024-06-28 Published:2024-09-15 Online:2024-09-06
Contact: ^△E-mail：lijian_umc@sina.com

张志华, 常泰浩, 罗飞, 王亚申, 李健. 同期前列腺穿刺联合PVP对高龄、高危、可疑前列腺癌患者的疗效及安全性[J]. 天津医药, 2024, 52(9): 959-962.

ZHANG Zhihua, CHANG Taihao, LUO Fei, WANG Yashen, LI Jian. Efficacy and safety of simultaneous prostate biopsy combined with PVP in the treatment of elderly, high-risk and suspected prostate cancer patients[J]. Tianjin Medical Journal, 2024, 52(9): 959-962.

摘要/Abstract

摘要：

目的探讨同期经会阴前列腺穿刺活检术联合经尿道前列腺绿激光汽化术（PVP）治疗高龄、高危、可疑前列腺癌（PCa）患者的疗效及安全性。方法回顾性分析37例年龄≥70岁、伴有合并症、可疑PCa患者的临床资料，记录患者手术时间、激光发光时间、术后膀胱冲洗时间、尿管留置时间及围手术期并发症，并随访患者国际前列腺症状评分（IPSS）、生活质量评分（QoL评分）、最大尿流率（Qmax）及残余尿量（PVR）。结果 37例患者均顺利完成手术，手术时间为58（42，67）min、激光发光时间为48（31，57）min。术中包膜穿孔1例（2.7%），中转经尿道前列腺电切术（TURP）1例（2.7%），无输血病例，术后无经尿道电切综合征（TURS）、严重血尿、尿潴留及二次手术病例，围手术期无新发急性心脑血管事件，无死亡病例。术后病理PCa 29例（78.4%），良性前列腺增生8例（21.6%）。术后12个月患者IPSS为5（4，5）分，QoL为2（2，3）分，Qmax为16（14，18）mL/s，PVR为30（24，35）mL，较术前均明显改善，PCa患者术后12个月总前列腺特异性抗原（tPSA）为0.05（0.02，0.37）μg/L，较术前下降（P<0.05）。结论同期经会阴前列腺穿刺活检术联合PVP可在明确诊断的同时解除下尿路梗阻，适用于高龄、高危、可疑PCa的高龄患者。

关键词: 前列腺肿瘤, 前列腺增生, 前列腺穿刺活检, 经尿道前列腺绿激光汽化术

Abstract:

Objective To investigate the efficacy and safety of simultaneous prostate biopsy combined with greenlight laser photoselective vaporization of prostate (PVP) in the treatment of elderly, high-risk and suspected prostate cancer (PCa) patients. Methods A retrospective analysis was performed on 37 elderly, high-risk and suspected PCa patients in Tianjin union medical center between June 2018 and December 2022. The surgical time, laser time, postoperative bladder irrigation time, catheter retention time and perioperative complications were recorded respectively. Furthermore, the patients were followed up regarding the International Prostate Symptom Score (IPSS score), Quality of Life Score (QoL score), Maximum Urinary Flow Rate (Qmax) and Residual Urine Volume (PVR). Results All patients were treated with the surgery successfully, with a surgical time of 58 (42,67) minutes and a laser time of 48 (31,57) minutes. There were 1 case (2.7%) of capsule perforation, 1 case (2.7%) of transfer to TURP, and no patients required blood transfusion. No patients had TUR syndrome（TURS）, severe hematuria, urinary retention secondary surgery, new acute cardiovascular and cerebrovascular events in the perioperative period. Based on postoperative pathology, 29 cases (78.4%) were PCa and 8 cases (21.6%) were benign prostatic hyperplasia. The IPSS [5 (4,5)], Qol [2 (2,3)], Qmax [16 (14,18) mL/s], and PVR [30 (24,35) mL] of all patients was improved significantly 12 months after the surgery. Besides, the tPSA level [0.05 (0.02,0.37) μg/L] of PCa patients was also significantly decreased. Conclusion Simultaneous prostate biopsy combined with PVP can provide clear diagnosis and improve urinary tract obstruction, and is suitable for elderly, high-risk and suspected PCa patients.

Key words: prostatic neoplasms, prostatic hyperplasia, prostate biopsy, greenlight laser photoselective vaporization of prostate

中图分类号:

R737.25

图/表 1

参考文献 24

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时间	IPSS/分		QoL/分		Qmax/（mL/s）
术前	32（28，34）		5（5，6）		5（2，6）
术后3个月	7（5，10）^a		3（2，3）^a		16（14，19）^a
术后6个月	5（5，6）^a		2（2，3）^a		16（14，18）^a
术后12个月	5（4，5）^ab		2（2，3）^a		16（14，18）^a
χ²	80.053^＊＊		67.287^＊＊		69.167^＊＊
时间		PVR/mL		tPSA/（μg/L）^#
术前		400（160，555）		14.23（12.65，24.61）
术后3个月		53（36，65）^a		1.34（0.79，2.35）^a
术后6个月		45（28，52）^a		0.55（0.05，0.98）^ab
术后12个月		30（24，35）^ab		0.05（0.02，0.37）^ab
χ²		77.764^＊＊		72.073^＊＊

时间	IPSS/分		QoL/分		Qmax/（mL/s）
术前	32（28，34）		5（5，6）		5（2，6）
术后3个月	7（5，10）^a		3（2，3）^a		16（14，19）^a
术后6个月	5（5，6）^a		2（2，3）^a		16（14，18）^a
术后12个月	5（4，5）^ab		2（2，3）^a		16（14，18）^a
χ²	80.053^＊＊		67.287^＊＊		69.167^＊＊
时间		PVR/mL		tPSA/（μg/L）^#
术前		400（160，555）		14.23（12.65，24.61）
术后3个月		53（36，65）^a		1.34（0.79，2.35）^a
术后6个月		45（28，52）^a		0.55（0.05，0.98）^ab
术后12个月		30（24，35）^ab		0.05（0.02，0.37）^ab
χ²		77.764^＊＊		72.073^＊＊

同期前列腺穿刺联合PVP对高龄、高危、可疑前列腺癌患者的疗效及安全性

Efficacy and safety of simultaneous prostate biopsy combined with PVP in the treatment of elderly, high-risk and suspected prostate cancer patients

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