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

Authors：

, 

四川大学华西医院泌尿外科/泌尿外科研究所（成都 610041）;

Corresponding author：

, Email: yipinglu@163.com

Keywords：

前列腺增生; 前列腺动脉; 栓塞

DOI：

10.7507/1002-0179.201512162

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良性前列腺增生（benign prostatic hyperplasia，BPH）是困扰老年男性的常见疾病之一，目前其治疗主要靠药物治疗、手术治疗。虽然目前经尿道前列腺电切术仍是治疗 BPH 公认的金标准，但对高龄、体弱、伴发其他内科疾病者仍有一定的局限性。因此，对年龄较大且伴发合并症不适宜手术的 BPH 患者，选择一种效果好、并发症少的微创疗法尤其重要。目前认为 BPH 与前列腺上皮和间质细胞增殖、上皮细胞凋亡率下降以及新生血管形成有关。发生 BPH 时前列腺细胞增殖和血供丰富，而任何组织和器官若无血供或血供不足则会发生坏死和萎缩。据此，已有文献报道采用放射介入法栓塞前列腺动脉，人为阻断前列腺的部分血供，使增生前列腺的体积萎缩，减少对尿道的压迫性阻塞，从而可达到治疗目的。现有研究显示，该方法具有创伤小、并发症较少的特点，不失为一种治疗 BPH 可选择的方法。该文就其治疗 BPH 的研究进展进行了综述。

Citation： 王玉杰, 卢一平. . 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, 单诗山, 薛丽芳, 等. 前列腺炎的腺体血管彩色多普勒超声影象特点. 中国医学影像技术, 2001, 17(2): 173-174.
9.	王玲, 董昌元, 贺祎, 等. 经直肠彩色多普勒超声对前列腺增生和前列腺癌的血流动力学研究. 中国超声医学杂志, 2001, 17(2): 144-147.
10.	陈亚青, 周永昌, 黄慕民, 等. 彩色直方图估测前列腺血流的价值. 中国超声医学杂志, 2001, 17(5): 328-330.
11.	单诗山, 李建国, 张万蕾, 等. 良性前列腺增生的经直肠彩色多普勒超声特征. 中国超声医学杂志, 2002, 18(6): 472-474.
12.	申佳, 程涛. 增生前列腺的血供变化及其临床意义. 上海交通大学学报: 医学版, 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, 施小东, 邵勇, 等. 慢性缺血对大鼠前列腺组织结构的影响. 现代实用医学, 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, 颜志平, 唐仪, 等. 前列腺动脉栓塞治疗犬前列腺增生的初步研究. 中华放射学杂志, 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, 郑传胜, 王奇, 等. 经导管动脉栓塞术在经尿道前列腺电切后出血中的应用. 介入放射学杂志, 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.	郝树铭, 宋明山, 郝怀军. 放射介入法前列腺动脉栓塞治疗前列腺增生症(附15例报告). 山东医药, 2002, 42(11): 48.
24.	吕辉琴, 高元安, 程广林, 等. 动脉栓塞治疗良性前列腺增生的初步研究. 中华泌尿外科杂志, 2005, 26(12): 823-825.
25.	兰春虎. 经导管动脉栓塞治疗良性前列腺增生一例报道. 当代医学, 2009, 15(17): 378.
26.	高元安, 张瑞, 曾妍, 等. 动脉栓塞治疗前列腺增生临床疗效评价. 介入放射学杂志, 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, 张本斯, 杨月如. 前列腺动脉的解剖观测及临床应用. 局解手术学杂志, 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.	常钢, 陈志强, 杨志刚, 等. 前列腺动脉造影表现及方法探讨. 介入放射学杂志, 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, 单诗山, 薛丽芳, 等. 前列腺炎的腺体血管彩色多普勒超声影象特点. 中国医学影像技术, 2001, 17(2): 173-174.
9. 王玲, 董昌元, 贺祎, 等. 经直肠彩色多普勒超声对前列腺增生和前列腺癌的血流动力学研究. 中国超声医学杂志, 2001, 17(2): 144-147.
10. 陈亚青, 周永昌, 黄慕民, 等. 彩色直方图估测前列腺血流的价值. 中国超声医学杂志, 2001, 17(5): 328-330.
11. 单诗山, 李建国, 张万蕾, 等. 良性前列腺增生的经直肠彩色多普勒超声特征. 中国超声医学杂志, 2002, 18(6): 472-474.
12. 申佳, 程涛. 增生前列腺的血供变化及其临床意义. 上海交通大学学报: 医学版, 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, 施小东, 邵勇, 等. 慢性缺血对大鼠前列腺组织结构的影响. 现代实用医学, 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, 颜志平, 唐仪, 等. 前列腺动脉栓塞治疗犬前列腺增生的初步研究. 中华放射学杂志, 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, 郑传胜, 王奇, 等. 经导管动脉栓塞术在经尿道前列腺电切后出血中的应用. 介入放射学杂志, 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. 郝树铭, 宋明山, 郝怀军. 放射介入法前列腺动脉栓塞治疗前列腺增生症(附15例报告). 山东医药, 2002, 42(11): 48.
24. 吕辉琴, 高元安, 程广林, 等. 动脉栓塞治疗良性前列腺增生的初步研究. 中华泌尿外科杂志, 2005, 26(12): 823-825.
25. 兰春虎. 经导管动脉栓塞治疗良性前列腺增生一例报道. 当代医学, 2009, 15(17): 378.
26. 高元安, 张瑞, 曾妍, 等. 动脉栓塞治疗前列腺增生临床疗效评价. 介入放射学杂志, 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, 张本斯, 杨月如. 前列腺动脉的解剖观测及临床应用. 局解手术学杂志, 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. 常钢, 陈志强, 杨志刚, 等. 前列腺动脉造影表现及方法探讨. 介入放射学杂志, 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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