Prostate Cancer P D:Rezūm水蒸气疗法治疗尿潴留伴导尿管依赖的多病患者

2021-10-08 AlexYang MedSci原创

调查了这种方法对于治疗复发性尿潴留和导尿管依赖多病患者的安全性和有效性,这些患者均不适合进行手术。

水蒸气热疗法(Rezūm)是一种治疗良性前列腺增生(BPE)的微创疗法。

近期,来自澳大利亚的研究人员在《Prostate Cancer P D》上发表文章,调查了这种方法对于治疗复发性尿潴留和导尿管依赖多病患者的安全性和有效性,这些患者均不适合进行手术

研究人员评估了136名复发性尿潴留患者,他们在2017年11月至2021年2月期间,在三个泌尿科室接受了水蒸气疗法,并在非住院情况下进行了前列腺周围阻滞和选择性镇静。治疗目标是成功拔出导尿管,并在治疗后3个月和12个月不依赖导尿管。

患者平均年龄为80.3岁(±7.8),平均前列腺体积为54毫升(±27.3),治疗前的平均导管依赖时间为4.8个月(±6.0)。 按美国麻醉师协会(ASA)标准分类,分别为II类:10%,III类:71%,IV类:19%。所有手术都在非住院条件下成功进行。结果发现,围手术期并发症不多,而且轻微(Clavien-Dindo 1-2级),包括4.4%的血尿和3.9%的尿路感染。共有103名患者(78.6%)在31天(中位数)后能够自行排空。在治疗成功和不成功患者之间,年龄、前列腺体积、导管依赖时间、蒸汽注入和ASA评分均无明显差异。平均随访时间为6.1个月(±5.9,范围1-22个月);77名患者(75%)有3个月的随访,34名患者(33%)有12个月的随访。3个月和12个月随访的患者中,分别有93.5%和91%的患者保持不依赖导管。15名患者(11%)在随访期间死亡,平均总生存期为7.7个月(±4.7)。

患者结果和手术数据

综上所述,水蒸气疗法是一种有用的、微创的治疗方法,适用于继发于BPE的尿潴留,且有导尿管依赖的多病人群。但仍需进一步的研究评估。

原始出处:

K Eredics , C Wehrberger , A Henning et al. Rezūm water vapor therapy in multimorbid patients with urinary retention and catheter dependency. Prostate Cancer P D. Sep 2021

 

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    2021-10-10 lsndxfj
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    2021-10-10 sunylz

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