<trans-title xml:lang="en"/>_West China Medical Journal

Authors：

, 

四川大學華西醫院泌尿外科/泌尿外科研究所（成都 ?610041）;

Corresponding?author：

, Email: yipinglu@163.com

Keywords：

前列腺增生; 前列腺動脈; 栓塞

DOI：

10.7507/1002-0179.201512162

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良性前列腺增生（benign prostatic hyperplasia，BPH）是困擾老年男性的常見疾病之一，目前其治療主要靠藥物治療、手術治療。雖然目前經尿道前列腺電切術仍是治療 BPH 公認的金標準，但對高齡、體弱、伴發其他內科疾病者仍有一定的局限性。因此，對年齡較大且伴發合并癥不適宜手術的 BPH 患者，選擇一種效果好、并發癥少的微創療法尤其重要。目前認為 BPH 與前列腺上皮和間質細胞增殖、上皮細胞凋亡率下降以及新生血管形成有關。發生 BPH 時前列腺細胞增殖和血供豐富，而任何組織和器官若無血供或血供不足則會發生壞死和萎縮。據此，已有文獻報道采用放射介入法栓塞前列腺動脈，人為阻斷前列腺的部分血供，使增生前列腺的體積萎縮，減少對尿道的壓迫性阻塞，從而可達到治療目的。現有研究顯示，該方法具有創傷小、并發癥較少的特點，不失為一種治療 BPH 可選擇的方法。該文就其治療 BPH 的研究進展進行了綜述。

Citation： 王玉杰, 盧一平. . West China Medical Journal, 2017, 32(2): 271-276. doi: 10.7507/1002-0179.201512162 Copy

1.	Rowhrborm CG, McConnell JD. Etiology, pathothysiology, epidemiology and natural history of benign prostatic hyperplasia//walsh PC, Retik AB, Vaughan ED, et al. Campbell’s Urology. Philadelphia: WB Saunders Compan, 2002: 1297-1330.
2.	Berry MJ, Coffey DS, Walsh PC, et al. The development of human benign prostatic hyperplasia with age. J Urol, 1984, 132(3): 474-479.
3.	Gu L, Xia L, Kong T. Preliminary study of the frequency of benign prostatic hyperplasia and prostatic cancer in China. Urology, 1994, 44(5): 688-691.
4.	Society of Interventional Radiology. Nonsurgical treatment turns back the clock, shrinks enlarged prostate[EB/OL]. (2013-04-15)[2017-01-16]. http://www.sciencedaily.com/ releases/2013/04/130415124817.html.
5.	Antunes AA, Carnevale FC, da Motta Leal Filho JM, et al. Clinical, laboratorial, and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia. A prospective single-center pilot study. Cardiovasc Intervent Radiol, 2013, 36(4): 978-986.
6.	Pisco JM, Pinheiro LC, Bilhim T, et al. Prostatic arterial embolization to treat benign prostatic hyperplasia. J Vasc Interv Radiol, 2011, 22(1): 11-19.
7.	Pisco JM, Rio Tinto H, Campos Pinheiro L, et al. Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of short- and mid-term follow-up. Eur Radiol, 2013, 23(9): 2561-2572.
8.	毛汛, 單詩山, 薛麗芳, 等. 前列腺炎的腺體血管彩色多普勒超聲影象特點. 中國醫學影像技術, 2001, 17(2): 173-174.
9.	王玲, 董昌元, 賀祎, 等. 經直腸彩色多普勒超聲對前列腺增生和前列腺癌的血流動力學研究. 中國超聲醫學雜志, 2001, 17(2): 144-147.
10.	陳亞青, 周永昌, 黃慕民, 等. 彩色直方圖估測前列腺血流的價值. 中國超聲醫學雜志, 2001, 17(5): 328-330.
11.	單詩山, 李建國, 張萬蕾, 等. 良性前列腺增生的經直腸彩色多普勒超聲特征. 中國超聲醫學雜志, 2002, 18(6): 472-474.
12.	申佳, 程濤. 增生前列腺的血供變化及其臨床意義. 上海交通大學學報: 醫學版, 2015, 35(3): 414-417.
13.	Sun F, Sánchez FM, Crisóstomo V, et al. Benign prostatic hyperplasia: transcatheter arterial embolization as potential Treatment: preliminary study in pigs. Radiology, 2008, 246(3): 783-789.
14.	Jeon GS, Won JH, Lee BM, et al. The effect of transarterial prostate embolization in hormone-induced benign prostatic hyperplasia in dogs: a pilot study. J Vasc Interv Radiol, 2009, 20(3): 384-390.
15.	Sun F, Sánchez FM, Crisóstomo V, et al. Transarterial prostatic embolization: initial experience in a canine model. AJR Am J Roentgenol, 2011, 197(2): 495-501.
16.	邱中笑, 施小東, 邵勇, 等. 慢性缺血對大鼠前列腺組織結構的影響. 現代實用醫學, 2011, 23(5): 579-580, 封3.
17.	Brook OR, Faintuch S, Brook A, et al. Embolization therapy for benign prostatic hyperplasia: influence of embolization particle size on gland perfusion. J Magn Reson Imaging, 2013, 38(2): 380-387.
18.	方主亭, 顏志平, 唐儀, 等. 前列腺動脈栓塞治療犬前列腺增生的初步研究. 中華放射學雜志, 2013, 47(6): 551-554.
19.	Küss R, Merland J, Le Guillou M, et al. Embolization of prostatic arteries, a rescue approach in uncontrolled hemorrhage after adenomectomy (proceedings). J Urol Nephrol (Paris), 1978, 84(6): 476-480.
20.	Debruyne M. Review of the current possibilities for arterial embolization in urology. Arch Chir Neerl, 1979, 31(2): 85-92.
21.	熊斌, 鄭傳勝, 王奇, 等. 經導管動脈栓塞術在經尿道前列腺電切后出血中的應用. 介入放射學雜志, 2012, 21(8): 630-632.
22.	Demeritt JS, Elmasri FF, Esposito MP, et al. Relief of benign prostatic hyperplasia-related bladder outlet obstruction after transarterial polyvinyl alcohol prostate embolization. J Vasc Interv Radiol, 2000, 11(6): 767-770.
23.	郝樹銘, 宋明山, 郝懷軍. 放射介入法前列腺動脈栓塞治療前列腺增生癥(附15例報告). 山東醫藥, 2002, 42(11): 48.
24.	呂輝琴, 高元安, 程廣林, 等. 動脈栓塞治療良性前列腺增生的初步研究. 中華泌尿外科雜志, 2005, 26(12): 823-825.
25.	蘭春虎. 經導管動脈栓塞治療良性前列腺增生一例報道. 當代醫學, 2009, 15(17): 378.
26.	高元安, 張瑞, 曾妍, 等. 動脈栓塞治療前列腺增生臨床療效評價. 介入放射學雜志, 2010, 19(1): 20-22.
27.	Carnevale FC, Antunes AA, da Motta Leal Filho JM, et al. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc Intervent Radiol, 2010, 33(2): 355-361.
28.	Carnevale FC, Da Motta-Leal-Filho JM, Antunes AA, et al. Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. J Vasc Interv Radiol, 2013, 24(4): 535-542.
29.	Pisco J, Campos Pinheiro L, Bilhim T, et al. Prostatic arterial embolization for benign prostatic hyperplasia: short- and intermediate-term results. Radiology, 2013, 266(2): 668-677.
30.	Wang MQ, Guo LP, Zhang GD, et al. Prostatic arterial embolization for the treatment of lower urinary tract symptoms due to large (>80 mL) benign prostatic hyperplasia: results of midterm follow-up from Chinese population. BMC Urol, 2015, 15(1): 33.
31.	Schreuder SM, Scholtens AE, Reekers JA, et al. The role of prostatic arterial embolization in patients with benign prostatic hyperplasia: a systematic review. Cardiovasc Intervent Radiol, 2014, 37(5): 1198-1219.
32.	Wang M, Guo L, Duan F, et al. Prostatic arterial embolization for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia: a comparative study of medium- and large-volume prostates. BJU Int, 2016, 117(1): 155-164.
33.	Fernandes L, Rio Tinto H, Pereira J, et al. Prostatic arterial embolization: post-procedural follow-up. Tech Vasc Interv Radiol, 2012, 15(4): 294-299.
34.	Gao YA, Huang Y, Zhang R, et al. Benign prostatic hyperplasia: prostatic arterial embolization versus transurethral resection of the prostate-a prospective, randomized, and controlled clinical trial. Radiology, 2014, 270(3): 920-928.
35.	Ambrósio D, De Almeida S, De Souza A. Origin of prostatic arteries in man. Rev Paul Med, 1981, 96(3/4): 52-55.
36.	李光忠, 張本斯, 楊月如. 前列腺動脈的解剖觀測及臨床應用. 局解手術學雜志, 2005, 14(2): 73-75.
37.	Garcia-Monaco R, Garategui L, Kizilevsky N, et al. Human cadaveric specimen study of the prostatic arterial anatomy: implications for arterial embolization. J Vasc Interv Radiol, 2014, 25(2): 315-322.
38.	常鋼, 陳志強, 楊志剛, 等. 前列腺動脈造影表現及方法探討. 介入放射學雜志, 2004, 13(1): 28-30.
39.	Bilhim T, Casal D, Furtado A, et al. Branching patterns of the male internal iliac artery: imaging findings. Surg Radiol Anat, 2011, 33(2): 151-159.
40.	Bilhim T, Tinto HR, Fernandes L, et al. Radiological anatomy of prostatic arteries. Tech Vasc Interv Radiol, 2012, 15(4): 276-285.
41.	Bilhim T, Pisco J, Campos Pinheiro L, et al. Does polyvinyl alcohol particle size change the outcome of prostatic arterial embolization for benign prostatic hyperplasia? Results from a single-center randomized prospective study. J Vasc Interv Radiol, 2013, 24(11): 1595-1602.

1. Rowhrborm CG, McConnell JD. Etiology, pathothysiology, epidemiology and natural history of benign prostatic hyperplasia//walsh PC, Retik AB, Vaughan ED, et al. Campbell’s Urology. Philadelphia: WB Saunders Compan, 2002: 1297-1330.
2. Berry MJ, Coffey DS, Walsh PC, et al. The development of human benign prostatic hyperplasia with age. J Urol, 1984, 132(3): 474-479.
3. Gu L, Xia L, Kong T. Preliminary study of the frequency of benign prostatic hyperplasia and prostatic cancer in China. Urology, 1994, 44(5): 688-691.
4. Society of Interventional Radiology. Nonsurgical treatment turns back the clock, shrinks enlarged prostate[EB/OL]. (2013-04-15)[2017-01-16]. http://www.sciencedaily.com/ releases/2013/04/130415124817.html.
5. Antunes AA, Carnevale FC, da Motta Leal Filho JM, et al. Clinical, laboratorial, and urodynamic findings of prostatic artery embolization for the treatment of urinary retention related to benign prostatic hyperplasia. A prospective single-center pilot study. Cardiovasc Intervent Radiol, 2013, 36(4): 978-986.
6. Pisco JM, Pinheiro LC, Bilhim T, et al. Prostatic arterial embolization to treat benign prostatic hyperplasia. J Vasc Interv Radiol, 2011, 22(1): 11-19.
7. Pisco JM, Rio Tinto H, Campos Pinheiro L, et al. Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of short- and mid-term follow-up. Eur Radiol, 2013, 23(9): 2561-2572.
8. 毛汛, 單詩山, 薛麗芳, 等. 前列腺炎的腺體血管彩色多普勒超聲影象特點. 中國醫學影像技術, 2001, 17(2): 173-174.
9. 王玲, 董昌元, 賀祎, 等. 經直腸彩色多普勒超聲對前列腺增生和前列腺癌的血流動力學研究. 中國超聲醫學雜志, 2001, 17(2): 144-147.
10. 陳亞青, 周永昌, 黃慕民, 等. 彩色直方圖估測前列腺血流的價值. 中國超聲醫學雜志, 2001, 17(5): 328-330.
11. 單詩山, 李建國, 張萬蕾, 等. 良性前列腺增生的經直腸彩色多普勒超聲特征. 中國超聲醫學雜志, 2002, 18(6): 472-474.
12. 申佳, 程濤. 增生前列腺的血供變化及其臨床意義. 上海交通大學學報: 醫學版, 2015, 35(3): 414-417.
13. Sun F, Sánchez FM, Crisóstomo V, et al. Benign prostatic hyperplasia: transcatheter arterial embolization as potential Treatment: preliminary study in pigs. Radiology, 2008, 246(3): 783-789.
14. Jeon GS, Won JH, Lee BM, et al. The effect of transarterial prostate embolization in hormone-induced benign prostatic hyperplasia in dogs: a pilot study. J Vasc Interv Radiol, 2009, 20(3): 384-390.
15. Sun F, Sánchez FM, Crisóstomo V, et al. Transarterial prostatic embolization: initial experience in a canine model. AJR Am J Roentgenol, 2011, 197(2): 495-501.
16. 邱中笑, 施小東, 邵勇, 等. 慢性缺血對大鼠前列腺組織結構的影響. 現代實用醫學, 2011, 23(5): 579-580, 封3.
17. Brook OR, Faintuch S, Brook A, et al. Embolization therapy for benign prostatic hyperplasia: influence of embolization particle size on gland perfusion. J Magn Reson Imaging, 2013, 38(2): 380-387.
18. 方主亭, 顏志平, 唐儀, 等. 前列腺動脈栓塞治療犬前列腺增生的初步研究. 中華放射學雜志, 2013, 47(6): 551-554.
19. Küss R, Merland J, Le Guillou M, et al. Embolization of prostatic arteries, a rescue approach in uncontrolled hemorrhage after adenomectomy (proceedings). J Urol Nephrol (Paris), 1978, 84(6): 476-480.
20. Debruyne M. Review of the current possibilities for arterial embolization in urology. Arch Chir Neerl, 1979, 31(2): 85-92.
21. 熊斌, 鄭傳勝, 王奇, 等. 經導管動脈栓塞術在經尿道前列腺電切后出血中的應用. 介入放射學雜志, 2012, 21(8): 630-632.
22. Demeritt JS, Elmasri FF, Esposito MP, et al. Relief of benign prostatic hyperplasia-related bladder outlet obstruction after transarterial polyvinyl alcohol prostate embolization. J Vasc Interv Radiol, 2000, 11(6): 767-770.
23. 郝樹銘, 宋明山, 郝懷軍. 放射介入法前列腺動脈栓塞治療前列腺增生癥(附15例報告). 山東醫藥, 2002, 42(11): 48.
24. 呂輝琴, 高元安, 程廣林, 等. 動脈栓塞治療良性前列腺增生的初步研究. 中華泌尿外科雜志, 2005, 26(12): 823-825.
25. 蘭春虎. 經導管動脈栓塞治療良性前列腺增生一例報道. 當代醫學, 2009, 15(17): 378.
26. 高元安, 張瑞, 曾妍, 等. 動脈栓塞治療前列腺增生臨床療效評價. 介入放射學雜志, 2010, 19(1): 20-22.
27. Carnevale FC, Antunes AA, da Motta Leal Filho JM, et al. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc Intervent Radiol, 2010, 33(2): 355-361.
28. Carnevale FC, Da Motta-Leal-Filho JM, Antunes AA, et al. Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. J Vasc Interv Radiol, 2013, 24(4): 535-542.
29. Pisco J, Campos Pinheiro L, Bilhim T, et al. Prostatic arterial embolization for benign prostatic hyperplasia: short- and intermediate-term results. Radiology, 2013, 266(2): 668-677.
30. Wang MQ, Guo LP, Zhang GD, et al. Prostatic arterial embolization for the treatment of lower urinary tract symptoms due to large (>80 mL) benign prostatic hyperplasia: results of midterm follow-up from Chinese population. BMC Urol, 2015, 15(1): 33.
31. Schreuder SM, Scholtens AE, Reekers JA, et al. The role of prostatic arterial embolization in patients with benign prostatic hyperplasia: a systematic review. Cardiovasc Intervent Radiol, 2014, 37(5): 1198-1219.
32. Wang M, Guo L, Duan F, et al. Prostatic arterial embolization for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia: a comparative study of medium- and large-volume prostates. BJU Int, 2016, 117(1): 155-164.
33. Fernandes L, Rio Tinto H, Pereira J, et al. Prostatic arterial embolization: post-procedural follow-up. Tech Vasc Interv Radiol, 2012, 15(4): 294-299.
34. Gao YA, Huang Y, Zhang R, et al. Benign prostatic hyperplasia: prostatic arterial embolization versus transurethral resection of the prostate-a prospective, randomized, and controlled clinical trial. Radiology, 2014, 270(3): 920-928.
35. Ambrósio D, De Almeida S, De Souza A. Origin of prostatic arteries in man. Rev Paul Med, 1981, 96(3/4): 52-55.
36. 李光忠, 張本斯, 楊月如. 前列腺動脈的解剖觀測及臨床應用. 局解手術學雜志, 2005, 14(2): 73-75.
37. Garcia-Monaco R, Garategui L, Kizilevsky N, et al. Human cadaveric specimen study of the prostatic arterial anatomy: implications for arterial embolization. J Vasc Interv Radiol, 2014, 25(2): 315-322.
38. 常鋼, 陳志強, 楊志剛, 等. 前列腺動脈造影表現及方法探討. 介入放射學雜志, 2004, 13(1): 28-30.
39. Bilhim T, Casal D, Furtado A, et al. Branching patterns of the male internal iliac artery: imaging findings. Surg Radiol Anat, 2011, 33(2): 151-159.
40. Bilhim T, Tinto HR, Fernandes L, et al. Radiological anatomy of prostatic arteries. Tech Vasc Interv Radiol, 2012, 15(4): 276-285.
41. Bilhim T, Pisco J, Campos Pinheiro L, et al. Does polyvinyl alcohol particle size change the outcome of prostatic arterial embolization for benign prostatic hyperplasia? Results from a single-center randomized prospective study. J Vasc Interv Radiol, 2013, 24(11): 1595-1602.

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