非那雄胺对热膨胀螺旋形前列腺内支架治疗良性前列腺增生术后的长期影响  

Long-term effect of finasteride on high-risk patients with benign prostatic hyperplasia after implantation of thermo-expandable spiral prostatic stent

作　　者：易晓明 何昊玮 许松 曾韬 韩德晃 周文泉 葛京平 薛松 YI Xiao-ming;HE Hao-wei;XU Song;ZENG Tao;HAN De-huang;ZHOU Wen-quan;GE Jing-ping;XUE Song(Department of Urology,General Hospital of Eastern Theater Command,Nanjing,Jiangsu 210002,China)

机构地区：[1]东部战区总医院泌尿外科,江苏南京210002

出　　处：《中华男科学杂志》2022年第12期1065-1070,共6页National Journal of Andrology

基　　金：国家自然科学基金(82072836)

摘　　要：目的:探讨非那雄胺对热膨胀螺旋形前列腺内支架治疗高危良性前列腺增生(BPH)术后的长期影响。方法:收集东部战区总医院年2017年1月至2019年1月63例成功进行热膨胀螺旋形前列腺内支架植入术的BPH患者资料,除2例因感染行支架取出术外,其余61例分为两组,长期服药组37例术后长期接受非那雄胺治疗超过12个月,对照组24例为接受非那雄胺治疗不足12个月,于术后3、6、12、24、36、48个月进行随访,观察两组患者术后血尿、感染、国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、残余尿量(PVR)等情况。结果:长期服药组患者术后48个月出血及感染发生率明显低于对照组(P<0.05);随着治疗时间的延长,各组血尿及感染发生率明显增加。支架置入术后3个月总体有效率高达95.1%,但随着治疗时间的延长,有效率呈进行性下降,术后48个月总体有效率仅为63.6%,长期服药组有效率为69.2%显著高于对照组的55.6%。在IPSS评分、Qmax、PVR等指标上长期服药组也优于对照组,具有统计学差异(P<0.05)。结论:热膨胀螺旋形前列腺支架治疗BPH引起的排尿困难远期疗效确切,对高危且不适宜手术的BPH患者可作为首选方法,非那雄胺在预防前列腺支架置入术后出血、感染具有明显优势,支架置入术后长期服用非那雄胺能够改善患者的远期疗效。Objective:To investigate the long-term effect of finasteride(FS)on high-risk BPH patients after treated by implantation of thermo-expandable spiral prostatic stent(TESPS).Methods:We retrospectively analyzed the clinical data on 63 cases of BPH treated by implantation of TESPS in our Department of Urology from January 2017 to January 2019.All the patients received oral FS after operation except two cases of stent removal because of infection,37 for more than 12 months(the long-term FS group)and the other 24 for less than 12 months(the control group).We followed up the patients at 3,6,12,24,36 and 48 months postoperatively,recorded the incidence of hematuria and infection,IPSS,maximum urinary flow rate(Qmax)and residual urine volume(PVR),and compared them between the two groups of patients.Results:At 48 months after operation,the incidence rates of postoperative hematuria and infection were significantly lower in the long-term FS group than in the control(P<0.05),but evidently increasing with the prolonging of medication time.The total effectiveness rate was as high as 95.1%at 3 months,but only 63.6%at 48 months,significantly higher,however,in the long-term FS than in the control group(69.2%vs 55.6%,P<0.05),and the IPSS,Qmax and PVR were also remarkably higher in the former than in the latter group(P<0.05).Conclusion:The long-term effect of TESPS implantation is definite in the treatment of BPH-induced dysuria,and it can be used as a first-choice method for the patients at high risk and unsuitable for surgery.Finasteride has an evident advantage in preventing hematuria and infection after prostatic stent implantation,and long-term medication of finasteride improves long-term outcomes.

关 键 词：非那雄胺 良性前列腺增生 热膨胀螺旋形 前列腺支架 

分 类 号：R697[医药卫生—泌尿科学]