腹腔镜前列腺癌根治术治疗前列腺癌的临床研究

陈晓农 汤建儿 王翔

[摘要] 目的 研究腹腔鏡前列腺癌根治术治疗前列腺癌的疗效。 方法 选择2017年10月～2019年3月我院收治的前列腺癌患者94例作为研究对象，采用随机数表法分为对照组（n=47）和观察组（n=47）。对照组行开放式前列腺癌根治术，观察组行腹腔镜前列腺癌根治术，观察对比两组患者的手术一般指标、免疫功能[免疫球蛋白G（IgG）、免疫球蛋白A（IgA）、免疫球蛋白M（IgM）]、性激素水平[睾酮（T）、促卵泡激素（FSH）、黄体生成素（LH）]、性功能指标[国际勃起功能问卷量表（IIEF）、国际前列腺症状评分（IPSS）]以及术后并发症的发生情况。 结果 观察组手术、肠功能恢复以及住院时间均较对照组低，失血量较对照组少，差异有统计学意义（P<0.05）;术后观察组免疫功能IgG、IgA、IgM水平比对照组高，差异有统计学意义（P<0.05）;观察组性激素T、LH、FSH水平比对照组高，差异有统计学意义（P<0.05）;术后观察组IIEF-5高于对照组，IPSS各评分低于对照组，差异有统计学意义（P<0.05）;术后并发症发生率观察组4.26%（2/47）较对照组19.15%（9/47）低，差异有统计学意义（P<0.05）。 结论 腹腔镜下前列腺根治术可有效改善患者围术期指标，有助于提高免疫功能，有效调节机体性激素水平，保护性功能，且安全性高。

[关键词] 前列腺癌;腹腔镜前列腺癌根治术;性激素水平;免疫功能

[中图分类号] R699.8          [文献标识码] B          [文章编号] 1673-9701（2020）18-0051-04

Clinical study of laparoscopic radical prostatectomy for prostate cancer

CHEN Xiaonong1   TANG Jian'er1   WANG Xiang2

1.Department of Urology， Huzhou First People's Hospital in Zhejiang Province， Huzhou   313000， China; 2.Department of Scientific Research， Huzhou First People's Hospital， Huzhou   313000， China

[Abstract] Objective To study the efficacy of laparoscopic radical prostatectomy for prostate cancer. Methods Ninety-four patients with prostate cancer admitted to our hospital from October 2017 to March 2019 were selected as the research subjects， and were divided into a control group （n=47） and an observation group（n=47） by random number table method. The control group underwent radical prostatectomy， and the observation group underwent laparoscopic radical prostatectomy. The general surgical indicators， immune function [immunoglobulin G （IgG）， immunoglobulin A （IgA）， immune glob Protein M （IgM）]， sex hormone levels [testosterone （T）， follicle stimulating hormone （FSH）， luteinizing hormone （LH）]， sexual function [International Erectile Function Questionnaire （IIEF）， International Prostate Symptom Score （IPSS）] and the occurrence of postoperative complications were observed and compared. Results The time of surgery， recovery of intestinal function and hospitalization in the observation group were lower than those in the control group， and the blood loss in the observation group was less than that in the control group， with statistically significant difference（P<0.05）. The levels of immune function IgG， IgA and IgM in the observation group after operation were higher than those in the control group， and the difference was statistically significant（P<0.05）. The levels of sex hormones T， LH and FSH in the observation group were higher than those in the control group， and the difference was statistically significant（P<0.05）. Postoperative IIEF-5 in the observation group was higher than that of the control group， and IPSS scores in the observation group were lower than those of the control group， and the difference was statistically significant（P<0.05）. The incidence of postoperative complications in the observation group was 4.26%（2/47）， lower than that of the control group 19.15% （9/47）， and the difference was statistically significant（P<0.05）. Conclusion Laparoscopic radical prostatectomy can effectively improve the perioperative indicators of patients， help to improve immune function， effectively adjust the body's sex hormone levels， protect sex function， and have high safety.

[Key words] Prostate cancer; Laparoscopic radical prostatectomy; Sex hormone levels; Immune function

前列腺癌（Prostatic cancer，PCa）是常見的泌尿生殖系统恶性肿瘤，中老年是该疾病的多发人群。PCa发病较为隐匿，且该疾病进展较慢，主要于前列腺周边发病，且因为该疾病早期基本无特异性症状，因此多数患者忽略此病，错过最佳的治疗时机，导致该疾病致死率较高[1-2]。目前临床上治疗该疾病多以手术为主，前列腺癌根治术是治疗早期PCa的常用手段，有助于延长患者生存时间以及提高其生活质量[3-4]。传统开放式手术是较常使用的方式，但经该手术方式治疗的患者术后并发症发生率较高，影响术后患者机体康复速度[5-6]。腹腔镜微创手术近几年来迅速发展，具有创伤小、术后并发症少的优点。……