经尿道前列腺电切联合内分泌治疗晚期前列腺癌疗效分析

倪云

【摘要】 目的 探讨经尿道前列腺电切术（TURP）联合内分泌治疗晚期前列腺癌的临床疗效。

方法 选择2010年1月至2012年1月泌尿外科收治的80例晚期前列腺癌患者，根据治疗时间的不同分为实验组和对照组各40例。所有患者均行经尿道前列腺电切加双侧睾丸切除术治疗，对照组在此基础上不再行其他特殊治疗，实验组则在此基础上辅以内分泌治疗（氟他胺，每次0.25 g，每天3次口服），3个月后复查前列腺特异抗原（PSA），比较患者术前、术后最大尿流速、膀胱残余尿量及血PSA下降情况，国际前列腺症状评分（IPSS）及生活质量评分（QOL），统计患者1年、2年、3年生存率。

结果 术后第6个月，实验组患者IPSS、QOL评分、最大尿流速、残余尿量及血PSA等指标均显著优于对照组（P<001）。实验组患者在术后1年、2年、3年生存率上均显著高于对照组，差异均有统计学意义（P<005）。

结论 晚期前列腺癌患者应用TURP加双侧睾丸切除术安全有效，辅以内分泌治疗疗效更好。

【关键词】 前列腺癌；前列腺电切术；氟他胺

中图分类号：R737.25 文献标识码：A 文章编号：10031383（2014）02019503

DOI：10.3969/j.issn.10031383.2014.02.019

Analysis of the effect of transurethral resection of prostate combined with hormone therapy for advanced prostate cancer

[HJ1*2][HJ]

NI Yun

（Department of Urology， the Second People's Hospital of Huaihua，Huaihua 418400，Hunan，China）

[HJ2][HJ]

【Abstract】 Objective To investigate the efficacy of transurethral resection of prostate（TURP） combined with hormone theraphy in the treament of advanced prostate cancer.

Methods 80 patients with advanced prostate cancer admitted to urology department from Jan，2010 to Jan，2012，were divided into the experimental group and the control group with 40 cases in each group according to their treatment time.All patients underwent TURP and bilateral orchidectomy，based on which flutamide was given to the experimental group three times a day with 0.25 g each time by oral administration.No special treatment was added to the control group.The prostatespecific antigen（PSA） of both groups were reexamined after 3 months of treatment.Then，their maximum urinary flow rate，bladder urine residue，decrease of blood PSA，international prostate symptom score（IPSS）and quality of life（QOL）score before and after treatment were compared.In addition，their survival rate in the 1st year，second year and third year were counted.

Results After 6 months of treatment，indexes including IPSS，QOL score，maximum urinary flow rate，bladder urine residue and blood PSA of the experimental group were significantly better than those of the control group，so the difference was statistically significant（P<001）.And their first year，second year and third year survival rates were also obviously higher than those of the control group，so the difference was statistically significant（P<005）.

Conclusion TURP and bilateral orchidectomy is safe and effective for patients with advanced prostate cancer.If hormone therapy was added to it，it will have better curative effect.

【Key words】 advanced prostate cancer；TURP；flutamide

前列腺癌在我国发病率高，可以达到9.92/10万，位列男性恶性肿瘤发病率的第6位，近些年来更是显出逐年递增趋势[1]。晚期前列腺癌患者多有较多并发症，如增大的肿块压迫尿道而造成的后尿道梗阻，造成排尿困难及尿潴留，严重影响着患者的生活质量[2]。对于晚期前列腺癌患者的治疗方式选择仍有不小的争议。笔者选取2年来收治的80例晚期前列腺癌患者，经过不同的治疗，比较两组患者的疗效，分析经尿道前列腺电切术（TURP）联合内分泌治疗晚期前列腺癌的临床疗效，现将结果报告如下。……