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目的回顾性分析白膜下睾丸实质剜除术与药物去势治疗Ⅳ期前列腺癌的疗效及副作用的差异。方法 2005年01月～2011年10月采用白膜下睾丸实质剜除术(n=70)和诺雷德联合康士得(n=62)治疗Ⅳ期前列腺癌并进行随访,分析其肿瘤缓解时间、总生存时间、手术并发症及对患者心理的影响。结果随访时间1～59个月,手术组和药物组肿瘤缓解时间分别为18个月和17个月,两组差异无显著性(χ2=0.166,P=0.682),总生存时间分别为33个月和31个月,两组差异无显著性(χ2=0.080,P=0.778)。手术组发生术后并发症的比率为10%,没有出现因睾丸切除导致的心理疾病。结论白膜下睾丸实质剜除术作为Ⅳ期前列腺癌白膜下睾丸实质剜除方法,具有疗效确切、对心理影响少及成本低的特点,可作为Ⅳ期激素依赖型前列腺癌去势治疗的首选方法。
Objective To retrospectively analyze the curative effect and side effects of prostate cancer treated with subcutaneous submucosal pterygium excision and drug castration. Methods From January 2005 to October 2011, grade IV prostate cancer was treated with subcapsular testicular parenchymatous excision (n = 70) and Noreel combined with koster (n = 62), and their response time to tumor was analyzed , Total survival time, surgical complications and psychological impact on patients. Results The follow-up time ranged from 1 to 59 months. The response time of tumor in operation group and drug group were 18 months and 17 months respectively. There was no significant difference between the two groups (χ2 = 0.166, P = 0.682) and the total survival time was 33 Month and 31 months, there was no significant difference between the two groups (χ2 = 0.080, P = 0.778). The rate of postoperative complications in the operation group was 10%, there was no mental illness caused by orchidectomy. Conclusion Subcapsular testicular parenchymatous removal of the testes as subepithelial testes of stage Ⅳ prostate cancer has the characteristics of exact curative effect, low psychological impact and low cost. It can be used as ovariectomy for stage Ⅳ hormone-dependent prostate cancer Preferred method.