经尿道前列腺等离子切除术中非那雄胺减少出血的疗效观察  

Effect of finasteride on perioperative bleeding following transurethral plasmakinetic resection of prostate

作　　者：孙文功[1] 张杰[1] 刘德海[1] 孟庆泽[1] 李鹏[1] 

机构地区：[1]解放军第153中心医院泌尿外科,郑州450007

出　　处：《中华老年医学杂志》2012年第11期949-951,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨术前服用非那雄胺对经尿道前列腺等离子切除术（PKRP）中出血量的影响。方法将符合入选标准的118例前列腺增生患者分为安慰剂对照组40例、服药1周组（非那雄胺5mg／d，术前服用1周）40例和服药3个月组（非那雄胺5mg／d，术前服用3个月）38例。3组均行PKRP，对3组患者年龄、前列腺体积、国际前列腺症状评分（IPSS）、术中切除的前列腺质量、术中出血量、术中冲洗液量、手术时间、平均切除1g前列腺组织失血量进行比较。结果118例患者均顺利完成PKRP。与对照组比较，服药1周组和服药3个月组在年龄、前列腺体积、IPSS、术中切除的前列腺质量方面差异无统计学意义（P〉0．05），但术中失血量[（173．5±16．9）ml、（163．5±15．8）ml和（156．4±16．2）mi]、平均切除1g前列腺组织失血量[（8．6±4．8）ml／g、（7．4±5．4）ml／g和（6．6±5．6）ml／g]、手术时间[（72．5±16．2）min、（58．4±17．8）min和（56．7±16．5）min]、术中冲洗液量（（31．5±5．6）L、（26．4±6．2）L和（24．3±5．2）L]均显著降低，差异有统计学意义（P％0．05）；服药3个月组与服药1周组比较，在术中失血量、平均切除1g前列腺组织失血量、手术时间、术中冲洗液量均显著降低，差异有统计学意义（P％0．05）。结论术前服用非那雄胺能有效减少PKRP术中失血量，术前服用非那雄胺3个月以上者减少术中出血的疗效优于术前服用1周者。Objective To evaluate the effect of finasteride on perioperative bleeding following transurethral plasmakinetic resection of prostate （PKRP）. Methods A total of 118 patients with benign prostatic hyperplasia （BPH） undergoing PKRP were randomly divided into three groups： 40 cases received 5mg of finasteride daily for 7 days before surgery as 1 week group, 38 cases received 5mg of finasteride daily for 3 months before surgery as 3 months group, the other 40 cases without taking finasteride before surgery as control group. A comparative study of clinical data was made among the three groups. Results The operation was successfully completed in 118 cases. As compared to control group, intraoperative irrigating fluid volume（（31.5 ± 5.6） L vs. （26.4± 6.2） L and （24.3±5.2）L], intraoperative blood loss〈（173.5±16.9） ml vs. （163.5±15.8） mland （156.4±16.2） m13, loss of 1 gram prostate tissue for resection（（8.6± 4.8）ml/g vs. （7.4 ±5.4） ml/g and （6.6±5.6） ml/g]and operation time（72.5±16.2） min vs. （58.4±17.8） rain and （56.7±16.5） rain in 1 week and 3 months groups with taking finasteride were decreased （all P〈0.05）. And there were differences in the above indexes （all P〈 0.05） between 1 week group and 3 months groups. Conclusions The use of finasteride before PKRP is safe and reliable to reduce perioperative bleeding in BPH patients. Moreover, taking 5mg of finasteride for three months is of better effectiveness than taking 5mg of finasteride for 1 week.

关 键 词：前列腺增生 经尿道前列腺切除术 非那特利 手术中并发症 

分 类 号：R699.8[医药卫生—泌尿科学]