介入栓塞治疗在高龄难治性前列腺癌出血中的临床效果
摘要
目的观察介入栓塞治疗在高龄难治性前列腺癌出血中的临床效果。方法前列腺癌合并持续性出血患者共80例,其中采用超选择性髂内动脉栓塞治疗患者58例,采用止血药物进行保守治疗患者22例。对比分析两组患者的成功止血时间、并发症等不良反应和复发出血的发生情况,评估超选择性介入栓塞治疗高龄难治性前列腺癌出血的疗效和安全性。结果介入栓塞治疗技术成功率100%,58例患者中,47例平均3 d血尿停止,8例转为镜下血尿,3例经第二次栓塞术后停止出血。栓塞术后无严重不良反应。术后平均随访12个月,复发出血5例。药物保守治疗22例患者中,5例平均7 d血尿停止,9例平均15 d转为镜下血尿,8例保守治疗失败,转为采用介入栓塞治疗后止血成功。保守治疗有效的14例患者中8例12个月内出血复发。结论超选择性介入栓塞治疗高龄难治性前列腺癌出血安全且有效。
引文
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2 石青,郭武华.介入治疗肝硬化门脉高压症并发食管胃底静脉曲张破裂出血研究进展[J].实用肝脏病杂志,2016;19(5):519-23.
3 Foremny GB,Pretell-Mazzini J,Jose J,et al.Risk of bleeding associated with interventional musculoskeletal radiology procedures.A comprehensive review of the literature[J].Skeletal Radiol,2015;44(5):619-27.
4 曹德宏,柳良仁,魏强,等.前列腺癌的治疗研究进展[J].华西医学,2017;32(2):277-81.
5 Chen JW,Shin JH,Tsao TF,et al.Prostatic arterial embolization for control of hematuria in patients with advanced prostate cancer[J].J Vasc Interv Radiol,2017;28(2):295-301.
6 刘碧天,吴斌.老年前列腺癌患者身体状态评估的研究进展[J].中华男科学杂志,2017;23(12):1132-7.
7 Lin YH,Hou CP,Chen TH,et al.Transurethral resection of the prostate provides more favorable clinical outcomes compared with conservative medical treatment in patients with urinary retention caused by benign prostatic obstruction[J].BMC Geriatr,2018;18(1):15.
8 Noh SM,Shin JH,Kim HI,et al.Clinical outcomes of angiography and transcatheter arterial embolization for acute gastrointestinal bleeding:analyses according to bleeding sites and embolization types[J].Korean J Gastroenterol,2018;71(4):219-28.
9 Jaganjac S,Schefe L.Palliative embolization of renal tumors[J].Vojnosanit Pregl,2015;72(12):1105-10.
10 Rao D,Yu H,Zhu H,et al.Superselective transcatheter renal artery embolization for the treatment of hemorrhage from non-iatrogenic blunt renal trauma:report of 16 clinical cases[J].Ther Clin Risk Manag,2014;10:455-8.
11 Jiang WX,Zhou ZE,Yan WG,et al.Unexpected hemorrhage of a rare vessel,a pubic branch of the external iliac artery,after laparoscopic radical prostatectomy:case report[J].Medicine (Baltimore),2017;96(50):e9357.