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目的:探索前列腺癌经皮冷冻治疗近期临床效果及并发症发生率。方法:使用ENDOCARE冷冻手术系统,经直肠超声引导,用2 mm冷冻刀经皮靶向冷冻前列腺癌,观察:①癌组织冷冻消融率;②并发症发生率;③手术前后PSA、PSMA的动态变化与疗效的关系。结果:①术后3周MR I显示:完全冷冻消融率34.8%(8/23);不完全冷冻消融率65.2%(15/23)。完全冷冻者术后6个月活检均呈阴性;未完全冷冻者活检阳性率为20%(3/15)。②术后轻度尿失禁发生率为13%(3/23),1月后均恢复正常。术后勃起功能障碍发生率为56.2%(9/16)。③氩氦刀治疗前后PSA水平分别为(32.98±35.50)μg/L、(11.65±26.51)μg/L,差异有统计学意义(P<0.05)。PSMA水平较术前上升显著。结论:经直肠超声引导经皮氩氦靶向冷冻治疗前列腺癌近期疗效满意,并发症少,创伤小。
Objective: To explore the clinical effect and the incidence of complications in the percutaneous freezing treatment of prostate cancer. Methods: Endocare frozen surgery system was used to guide the transrectal ultrasound guided percutaneous freezing of prostate cancer with 2 mm cryoablation. The degree of cryoablation and ablation of cancer tissues, the incidence of complications, the changes of PSA and PSMA before and after surgery were observed. Relationship with the effect. Results: ①The MR I of the three weeks postoperatively showed that the rate of complete thaw was 34.8% (8/23), and the rate of incomplete thaw was 65.2% (15/23). Completely frozen were biopsied 6 months after surgery were negative; not fully frozen biopsy positive rate of 20% (3/15). ② postoperative incidence of mild urinary incontinence was 13% (3/23), returned to normal after January. The incidence of postoperative erectile dysfunction was 56.2% (9/16). ③ The levels of PSA before and after argon-helium knife treatment were (32.98 ± 35.50) μg / L and (11.65 ± 26.51) μg / L, respectively, with statistical significance (P <0.05). PSMA level increased significantly compared with preoperative. Conclusion: Transrectal ultrasound-guided percutaneous argon-helium targeted cryotherapy for prostate cancer has satisfactory short-term outcomes with fewer complications and less trauma.