Đánh giá kết quả điều trị tăng sinh lành tính tuyến tiền liệt bằng nút mạch phối hợp hạt và keo sinh học=The results of the treatment of benign prostate hyperplasia by combined particles and biological glue embolization

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Trung Dũng Nghiêm, Hoàng Giang Phan, Đăng Lưu Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.24-29

Bộ sưu tập: Metadata

ID: 242656

Thêm vào giỏ

Describe the images of BPH on digital subtraction angiography (DSA) and magnetic resonance imaging (MRI). Evaluate the results of BPH treatment with embolization combined with particles and biological glue. Methods: From 09/2022 to 06/2024 at the Radiology Center, Bach Mai Hospital, we had 120 BPH patients treated with embolization. The patients were randomly divided into 2 groups: Group 1 received embolization with pure particles, Group 2 received embolization with particles combined with biological glue. Results: The average age of patients was 72.17 year-old. The technical success rate was 100% of patients, the clinical success rate was 116/120, accounting for 98%. In 120 patients undergoing DSA, 240 of the pelvic side, the prostatic artery originated from type 1 (46.7%), type 2 (2.9%), type 3 (20.8%), type 4 (23.3%), type 5 (9.5%) (according to Carneval). These patients were classified on pre-embolization MRI as type 1 (26.7%), type 2 (2.5%), type 3 (66.7%), type 4, 6, 7 (0.8%), type 5 (1.7%) (according to Wasserman). Group 1 had the following pre- and post- embolization indices at 12 months: IPSS from 27.93 decreased to 5.95, QoL from 5.41 improved to 1.97, Qmax from 8.3 increased to 13.6, PVR from 54 decreased to 22.45. Group 2 had the following pre- and post- embolization indices at 12 months: IPSS from 28.08 improved to 4.47, QoL from 5.35 improved to 1.72, Qmax from 6.74 increased to 13.08, PVR from 37.87 decreased to 19.52. These two groups had similar initial symptoms and improvement levels. After 12 months of embolization, group 1 had 8/60 recurrences, of which group 2 had 2/60 recurrences, a statistically significant difference with p = 0.043 <
0.05. Conclusion: Prostate embolization for the treatment of BPH is a safe and effective method, however, the recurrence rate is still high. Embolization combined with particles and biological glue can improve the recurrence rate for this method.Mô tả hình ảnh TSLTTTL trên chụp mạch số hóa xóa nền (DSA), cộng hưởng từ (MRI). Đánh giá kết quả điều trị TSLTTTL bằng nút mạch phối hợp hạt và keo sinh học. Đối tượng và phương pháp: Từ tháng 9/2022 đến tháng 6/2024 tại Trung tâm Điện quang, Bệnh viện Bạch Mai, chúng tôi có 120 bệnh nhân TSLTTTL được điều trị bằng nút mạch. Các bệnh nhân được chia ngẫu nhiên thành 2 nhóm: nhóm 1 được nút mạch bằng hạt đơn thuần, nhóm 2 được nút mạch bằng hạt phối hợp keo sinh học. Kết quả: Các bệnh nhân có tuổi trung bình 72,17 tuổi. Tỷ lệ thành công về kỹ thuật ở 100% bệnh nhân, tỷ lệ thành công về triệu chứng lâm sàng 116/120 chiếm 98%. Trong 120 bệnh nhân có 240 bên tiểu khung, động mạch tuyến tiền liệt có nguồn gốc xuất phát type 1 (46,7%), type 2 (2,9%), type 3 (20,8%), type 4 (23,3%), type 5 (9,5%) (theo Carneval). Các bệnh nhân này được phân loại trên cộng hưởng từ trước nút mạch type 1 (26,7%), type 2 (2,5%), type 3 (66,7%), type 4, 6, 7 cùng chiếm tỷ lệ (0,8%), type 5 (1,7%) (theo Wasserman). Nhóm 1 có các chỉ số trước và sau can thiệp 12 tháng tương ứng: IPSS từ 27,93 giảm còn 5,95, QoL từ 5,41 cải thiện còn 1,97, Qmax từ 8,3 tăng lên 13,6, PVR từ 54 giảm còn 22,45. Nhóm 2 có các chỉ số trước và sau can thiệp 12 tháng tương ứng: IPSS từ 28,08 cải thiện còn 4,47, QoL từ 5,35 cải thiện 1,72, Qmax từ 6,74 tăng lên 13,08, PVR từ 37,87 giảm còn 19,52. Hai nhóm này có triệu chứng ban đầu và mức độ cải thiện tương tự. Sau can thiệp 12 tháng, nhóm 1 có 8/60 ca tái phát, trong đó nhóm 2 có 2/60 ca tái phát, khác biệt có ý nghĩa thống kê với p = 0,043 <
0,05. Kết luận: Nút mạch điều trị TSLTTTL là phương pháp an toàn, hiệu quả, tuy nhiên tỷ lệ tái phát còn cao. Nút mạch phối hợp hạt và keo sinh học có thể cải thiện tỷ lệ tái phát cho phương pháp này.

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