【摘要】 目的 探讨锥形束CT（cone-beam computer tomography, CBCT）引导下前列腺动脉栓塞术（prostatic artery embolization, PAE）联合经尿道前列腺电切术（transurethral resection of the prostate, TURP）治疗大体积（>80 mL）良性前列腺增生（benign prostatic hyperplasia, BPH）的有效性及安全性。方法 回顾性分析苏州大学附属第一医院2017年1月至2023年6月收治的433例大体积BPH患者，经1∶2倾向性匹配分析后纳入99例，其中联合组33例（行CBCT引导下PAE联合TURP）,对照组66例（行单纯TURP）。比较两组患者围手术期指标、住院费用、术后并发症发生率，以及术后3、6、12个月国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率(Q_max)和残余尿量（PVR）。结果 围手术期指标比较显示，与对照组相比，联合组TURP手术时间（P<0.001）、膀胱冲洗时间（P<0.001）、导尿管留置时间（P<0.001）及术后住院时间（P=0.001）缩短、血红蛋白下降（P=0.027）;两组前列腺切除量、住院费用差异无统计学意义（P>0.05）。术后3个月，与对照组相比，联合组IPSS评分（P=0.025）和QOL评分（P=0.011）改善，Q_max与PVR差异无统计学意义（P>0.05）。术后6个月，联合组IPSS（P<0.001）、QOL（P=0.005）、Q_max（P=0.001）及PVR（P=0.028）优于对照组；术后12个月，联合组IPSS（P<0.001）、QOL（P<0.001）、Q_max（P<0.001）及PVR（P=0.019）仍优于对照组。联合组并发症发生率低于对照组（P=0.049）。结论 CBCT引导下PAE联合TURP治疗大体积BPH安全有效，远期疗效需进一步验证。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of cone-beam CT（CBCT）-guided prostatic artery embolization（PAE） combined with transurethral resection of the prostate（TURP） for benign prostatic hyperplasia（BPH） with prostate volume >80 mL.Methods The clinical data of 433 consecutive patients with large-volume BPH,who received treatment at the First Affiliated Hospital of Soochow University of China from January 2017 to June 2023,were retrospectively analyzed.After a 1∶2 propensity matching analysis, 99 patients were included in this study, including 33 patients in the combination group（undergoing CBCT-guided PAE combined with TURP） and 66 patients in the control group（undergoing only TURP）.Perioperative parameters, hospitalization costs, incidence of postoperative complications, and 3-,6-,and 12-month International Prostate Symptom Score（IPSS）,Quality of Life（QOL） score, maximum urinary flow rate(Q_max),and post-void residual volume（PVR） were compared between the two groups.Results Compared with the control group, the combination group had much shorter TURP surgery time（P<0.001）,bladder flushing time（P<0.001）,catheter retention time（P<0.001）,and postoperative hospitalization time（P=0.001）,and decreased hemoglobin level（P=0.027）.There were no statistically significant differences in the amount of prostate resection volume and hospitalization costs between the two groups（P>0.05）.Three months after treatment, the combination group showed improvement in IPSS score（P=0.025） and QOL score（P=0.011） when compared with the control group, while there were no statistically significant differences in Q_max and PVR between the two groups（P>0.05）.Six months after treatment, the IPSS（P<0.001）,QOL（P=0.005）,Q_max（P=0.001）,and PVR（P=0.028） in the combination group were better than those in the control group.At 12 months after treatment, the IPSS（P<0.001）,QOL（P<0.001）,Q_max（P<0.001）,and PVR（P=0.019） in the combination group were still better than those in the control group.The incidence of complications in the combination group was lower than that in the control group（P=0.049）.Conclusion For the treatment of large-volume BPH,CBCT-guided PAE combined with TURP is clinically safe and effective, although its long-term efficacy needs further verification.更多还原