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中华医学超声杂志(电子版) ›› 2018, Vol. 15 ›› Issue (11) : 869 -873. doi: 10.3877/cma.j.issn.1672-6448.2018.11.015

所属专题: 文献

介入超声影像学

超声引导下经会阴激光消融治疗良性前列腺增生(附2例报告)
黄斌1,(), 曹南2, 刘德林1, 孙希希1, 孔梓祥1, 王健生1   
  1. 1. 310023 浙江中医药大学附属杭州市西溪医院
    2. 310053 杭州,浙江中医药大学
  • 收稿日期:2018-08-09 出版日期:2018-11-01
  • 通信作者: 黄斌

Ultrasound-guided transperineal laser ablation on benign prostatic hyperplasia: 2 cases report

Bin Huang1,(), Nan Cao2, Delin Liu1, Xixi Sun1, Zixiang Kong1, Jiansheng Wang1   

  1. 1. Xixi Hospital of Hangzhou (the Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou 310023, China
    2. Zhejiang Chinese Medical University, Hangzhou 310053, China
  • Received:2018-08-09 Published:2018-11-01
  • Corresponding author: Bin Huang
  • About author:
    Corresponding author: Huang Bin, Email:
引用本文:

黄斌, 曹南, 刘德林, 孙希希, 孔梓祥, 王健生. 超声引导下经会阴激光消融治疗良性前列腺增生(附2例报告)[J/OL]. 中华医学超声杂志(电子版), 2018, 15(11): 869-873.

Bin Huang, Nan Cao, Delin Liu, Xixi Sun, Zixiang Kong, Jiansheng Wang. Ultrasound-guided transperineal laser ablation on benign prostatic hyperplasia: 2 cases report[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(11): 869-873.

目的

探讨超声引导下经会阴激光消融治疗良性前列腺增生(BPH)的安全性、可行性及其临床价值,探索BPH治疗的新方法。

方法

对药物治疗失效、不耐受常规手术的2例重度良性前列腺增生患者行经会阴激光消融治疗,术后超声造影评估消融范围,观察并发症发生等情况。术后1个月、2个月密切随访,进行疗效评估,并行影像学检查。

结果

2例患者术后即刻超声造影证实前列腺左、右侧内腺消融区较精确地符合术前手术方案,未发生明显并发症。术后2个月随访,2例患者下尿路症状均明显改善,国际前列腺症状评分(IPSS)分别由术前35分、32分降至术后5分、6分。前列腺体积分别由术前的62.7 ml、84.3 ml减小至术后61.2 ml、84.1 ml。

结论

经会阴BPH激光消融是一项安全、精准、最为微创的新方法,短期疗效显著,可为临床药物治疗失效、不耐受常规手术等困难BPH患者的治疗提供一种新思路。

Objective

To investigate the safety, feasibility and clinical value of the ultrasound-guided transperineal laser ablation (TPLA) for benign prostatic hyperplasia (BPH) and to explore a new method for BPH treatment.

Methods

Two patients with severe benign prostatic hyperplasia, who had experienced drug treatment failure and had intolerance to conventional surgery, were treated by TPLA. The postoperative range of ablation was evaluated by contrast-enhanced ultrasound and complications were observed. The patients were closely followed up in one and two months after operation. The curative effect was evaluated and the imaging examination was performed.

Results

The immediate contrast-enhanced ultrasound of the two patients confirmed that the ablation area of both left and right inner gland were in accordance with the preoperative surgical plan and no obvious complications were observed. The follow-ups after the operation suggested that the lower urinary tract symptoms of the two patients were significantly improved. The International Prostate Symptom Score (IPSS) decreased from 35 points and 32 points to 5 points and 6 points, respectively. The preoperative prostatic volumes were 62.7 ml and 84.3 ml, while the postoperative volumes were 61.2 ml and 84.1 ml, respectively.

Conclusion

TPLA is a safe, accurate and minimally invasive method with significant short-term curative effect, which can provide a new idea for the treatment of BPH with clinical drug treatment failure and non-tolerance to conventional surgery.

图2 超声引导下经会阴前列腺增生激光消融术中布针图像。图示超声引导下测量光纤位置及设计消融范围
图3,4 前列腺增生经会阴激光消融术后即刻超声造影图像。图示消融区无血管灌注,造影剂灌注缺失(粗箭头所示)。图3为超声造影横切面图像(细箭头所示为尿道无回声);图4为超声造影纵切面图像
表1 2例患者经会阴激光消融治疗术前及术后临床资料
1
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陈旖旎, 陈磊, 胡兵, 等. 超声引导下经会阴前列腺癌激光消融(附病例报告) [J]. 肿瘤影像学, 2016, 25(2): 137-142.
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张国栋, 段峰, 袁凯, 等. 前列腺动脉栓塞术治疗良性前列腺增生症的前景与挑战 [J].介入放射学杂志, 2014, 23(8): 735-738.
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