ABSTRACT
By analyzing the operation characteristic of community cooperative medical system in Guangzhou and the existing problem of basic medical insurance system in China, it provides the important value of exploring the implement of medical insurance system in China. Under the background of the low security level of basic medical insurance system in China is relative low, the disease risk is uncertain, medical needs diversification, medical cost inflation and the aging tendency of population, it is revealed to encourage the cooperative medical treatment of community with economic strength and enterprise development with similar enterprise annuity, as the supplement of the basic medical security system would help to compensate the lack of basic medical insurance system and meet the demand of diversified medical treatment.
ABSTRACT
Objective To evaluate the techniques and efficacy of artery embolization in the treatment of benign prostatic hyperplasia(BHP).Methods This study included 12 patients(age range,61-82 years) who were diagnosed to have BHP by clinical manifestations,CT and B-ultrasound,with the disease course of 2-16 years.The relevant parameters were as follows:mean residual urine(RU) of 138 ml,Qmax of 9.6 ml/s,mean IPSS of 24.2 and QOL of 4.8.In these patients,the prostate blood-supply arteries were confirmed by super-selective arteriography,and were embolized by injection of PVA and Gelfoam via artery catheters.The pre-and post-operative IPSS,QOL,Qmax and RU were compared.Meanwhile the changes of prostate volume and blood supply were evaluated by CT and B-ultrasound.In addition,the change of urethral diameter was evaluated by urethrography.Results In the 12 patients,21 prostate blood-supply arteries were embolized,including 5 branches of internal iliac artery,9 branches of inferior vesical artery,5 branches of internal pudendal artery,2 branches of obturator artery.The arteries were embolized bilaterally in 9 patients and embolized unilaterally in 3 patients.Postoperatively,the mean IPSS was 4.8;QOL,1.3;Qmax,18.9 ml/s;RU,0-3 ml,which indicated that the urethral obstruction was obviously improved after operation.CT and B-ultrasound showed that the prostate volume was obviously decreased from 127 ml to 90 ml on average with a reduction rate of 71%,and the urethral stricture disappeared on X-ray examination.Color Doppler imaging showed that the blood supply inside the prostate was reduced.Conclusions The artery embolization for the treatment of BHP is a new method with several virtues of less trauma, marked effect,better safety and fewer complications.