围手术期应用5α-还原酶抑制剂在经尿道双极等离子电切术治疗较大体积良性前列腺增生中的优势探讨  

Perioperative advantage of 5 alpha-reductase inhibitors in the treatment of large benign prostatic hyperplasia by bipolar transurethral plasmakinetic prostatectomy

作　　者：吴俊 左泽平[1] 宇洪涛[1] 钱俊杰[1] WU Jun;ZUO Zeping;YU Hongtao;QIAN Junjie(Department of Urology,the People's Hospital of Tongling,Tongling 244000,Anhui,China)

机构地区：[1]安徽省铜陵市人民医院泌尿外科,安徽铜陵244000

出　　处：《中国性科学》2020年第12期25-28,共4页Chinese Journal of Human Sexuality

摘　　要：目的探讨围手术期常规应用5α-还原酶抑制剂(5ARI)在经尿道双极等离子电切术(TUPKP)治疗较大体积良性前列腺增生(BPH)患者的术中术后优势。方法选取2014年10月至2019年8月铜陵市人民医院治疗的192例较大体积BPH患者的临床资料进行回顾性分析。按围手术期是否应用5ARI分为联合用药组(n=107)和单纯电切组(n=85)。比较两组患者术中手术时间、失血量、出血强度、前列腺切除组织量、前列腺腺体与尿道下黏膜微血管密度(MVD)变化,术后尿色转清时间、冲洗液体量、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)变化以及继发性出血并发症发生情况。结果联合用药组患者的手术时间、失血量、出血强度、前列腺腺体、尿道下黏膜MVD均小于单纯电切组患者,差异具有统计学意义(P<0.05);但两组患者前列腺组织切除量、IPSS、QOL、Qmax比较,差异无统计学意义(P>0.05);联合用药组患者术后尿色转清时间、冲洗液体量、继发性出血发生率明显小于单纯电切组患者,差异具有统计学意义(P<0.05)。结论围手术期应用5ARI在TUPKP治疗较大体积BPH中,能明显减少术中术后出血风险,具有安全可靠、效率高、恢复快等优势,适合在广大基层医院应用推广。Objective To explore the advantages of routine application of 5 alpha-reductase inhibitors(5 ARI)in the treatment of large benign prostatic hyperplasia(BPH)by bipolar transurethral plasmakinetic prostatectomy(TUPKP).Methods 192 patients with large volume BPH treated in the People′s Hospital of Tongling from October 2014 to August 2019 were retrospective analyzed.According to whether 5 ARI used or not during the perioperative period,the patients were divided into the combined drug group(n=107)and the simple electrotomy group(n=85).Operative time,blood loss,bleeding intensity,tissue volume of prostate resection,microvessel density(MVD)of prostate gland and hypospadias mucosa during operation were compared between the two groups.Urine color clearing time,the volume of flushing liquid,international prostate symptom score(IPSS),quality of life score(QOL),maximum urinary flow rate(Qmax),secondary bleeding complications postoperative during postoperative time were also compared.Results The operative time,blood loss,bleeding intensity,prostate gland,and suburethral mucosal MVD in the combined treatment group were all lower than those in the simple electrotomy group,and the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the amount of prostate tissue resection,IPSS,QOL and Qmax between the two groups(P>0.05).Postoperative urine color clearing time,amount of flushing fluid and incidence of secondary bleeding in the combined treatment group were significantly lower than those in the simple electrotomy group,and the differences were statistically significant(P<0.05).Conclusions Perioperative application of 5 ARI in TUPKP for the treatment of large volume BPH can significantly reduce the risk of intraoperative and postoperative bleeding.It has the advantages of security,high efficiency and fast recovery,and is suitable for the application and popularization in the majority of grassroots hospitals.

关 键 词：5Α-还原酶抑制剂 围手术期 经尿道双极等离子电切术 

分 类 号：R697[医药卫生—泌尿科学]