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目的探讨经尿道前列腺电汽化术(TVP)联合最大限度雄激素阻断疗法(MAB)治疗晚期前列腺癌的疗效。方法将78例晚期前列腺癌患者分为单纯TVP组(对照组,40例)和TVP与MAB联合治疗组(联合组,38例)两组,术后比较两组的疗效。结果与术前比较,78例前列腺癌患者术后1个月的主、客观症状改善,最大尿流率由(8.2±3.1)ml/s上升至(16.2±3.4)ml/s,残余尿量从(255.0±50.8)ml降至(23.0±8.4)ml,差异均有统计学意义(均P<0.05)。平均随访20个月后,与对照组比较,联合组患者骨痛减轻或消失,前列腺特异抗原水平降低更显著,前列腺体积缩小更明显,差异均有高度统计学意义(均P<0.01)。结论单纯TVP治疗中晚期前列腺癌是安全、有效的姑息疗法,联合MAB能有效减少下尿路梗阻再发率,同时显著改善晚期前列腺癌患者的临床症状和生活质量。
Objective To investigate the efficacy of transurethral electrovaporization (TVP) and maximal androgen blockade (MAB) in the treatment of advanced prostate cancer. Methods Seventy-eight patients with advanced prostate cancer were divided into two groups: TVP alone (control group, 40 cases) and TVP plus MAB combined treatment group (38 cases). The curative effect of the two groups were compared after operation. Results Compared with preoperative, 78 patients with prostate cancer had better objective and objective symptoms at one month after operation, and the maximum urinary flow rate increased from (8.2 ± 3.1) ml / s to (16.2 ± 3.4) ml / s and residual urine volume From (255.0 ± 50.8) ml to (23.0 ± 8.4) ml, the differences were statistically significant (all P <0.05). After a mean follow-up of 20 months, the bone pain in the combined group was reduced or disappeared compared with that in the control group. The prostate-specific antigen level decreased more significantly and the prostate volume decreased more significantly. The difference was highly statistically significant (both P <0.01). Conclusions Pure TVP is a safe and effective palliative treatment for advanced prostate cancer. Combined with MAB can effectively reduce the incidence of lower urinary tract obstruction and significantly improve the clinical symptoms and quality of life of patients with advanced prostate cancer.