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超选择性前列腺动脉栓塞术对前列腺增生的影响。

Effect of superselective prostatic artery embolization on benign prostatic hyperplasia.

机构信息

Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.

Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, 350001, China.

出版信息

Abdom Radiol (NY). 2021 Apr;46(4):1726-1736. doi: 10.1007/s00261-020-02782-2. Epub 2020 Oct 6.

Abstract

PURPOSE

To investigate the safety and effectiveness of superselective prostatic artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH).

METHODS

Sixty-five patients diagnosed with BPH in Fujian Provincial Hospital between December 2014 and July 2019 were included. Patients with ineffective drug treatment after 6 months, who refused surgery, or who were unsuitable for surgery were included. We observed postoperative complications, followed up at 1, 3, and 6 months, compared clinical symptoms, and monitored changes in prostate-specific antigen (PSA) and prostatic volume (PV) before and after treatment.

RESULTS

Of the 65 patients, 58 (89.23%) successfully received PAE; 44 and 14 bilateral and unilateral embolization, respectively. Clinical efficacy was 94.83% (55/58) after the 6-month follow-up. Postoperative PV, International Prostate Symptom Score, quality of life, maximum flow rate, and post-void residual significantly improved after 6 months (P < 0.05). One month after PAE, the serum total PSA increased by 1.47 (10.84/7.37) times and dropped 3 months later to a level lower than that before surgery (P < 0.05). Six months after PAE, the degree of relief from obstructive symptoms was more apparent than that of irritative symptoms. No serious complications were observed after PAE.

CONCLUSION

PAE was safe and effective for the treatment of BPH. The efficacy of bilateral PAE was better than that of unilateral PAE.

摘要

目的

探讨超选择性前列腺动脉栓塞术(PAE)治疗前列腺增生(BPH)的安全性和有效性。

方法

纳入 2014 年 12 月至 2019 年 7 月在福建省立医院诊断为 BPH 的 65 例患者。纳入标准:药物治疗 6 个月后无效、拒绝手术或不适合手术的患者。观察术后并发症,术后 1、3、6 个月随访,比较临床症状,监测治疗前后前列腺特异性抗原(PSA)和前列腺体积(PV)的变化。

结果

65 例患者中,58 例(89.23%)成功接受 PAE 治疗;其中 44 例为双侧 PAE,14 例为单侧 PAE。6 个月随访时临床疗效为 94.83%(55/58)。术后 6 个月 PV、国际前列腺症状评分、生活质量、最大尿流率和残余尿量均显著改善(P<0.05)。PAE 后 1 个月,血清总 PSA 升高 1.47 倍(10.84/7.37),3 个月后降至低于术前水平(P<0.05)。PAE 后 6 个月,梗阻症状缓解程度明显优于刺激症状。PAE 后未见严重并发症。

结论

PAE 治疗 BPH 安全有效,双侧 PAE 疗效优于单侧 PAE。

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