术前不同疗程非那雄胺对中重度前列腺增生手术出血的疗效观察

The effective course of finasteride pretreatment in decreasing blood loss associated with TURP

目的:探讨在中重度(前列腺体积大于40ml)前列腺增生(BPH)行经尿道前列腺电切(TURP)术前应用非那雄胺的最佳疗程。方法:对43例术前服用非那雄胺超过3个月(长程组)以及90例术前服用5～7天(短程组)的中重度BPH患者的临床资料,与同期78例未服用任何抗雄激素药物的中重度BPH手术患者的临床资料进行比较。结果:长程服药组TURP术中出血量、甘露醇的灌洗液量、电切操作时间、术者对术中视野的满意度、以及术后生理盐水连续冲洗膀胱的时间和所消耗的冲洗液量与对照组比较,差异均有统计学意义(P<0.05),而短程服药组除术后生理盐水连续冲洗膀胱的时间和所消耗的冲洗液量与对照组比较,差异有统计学意义外,其他指标的差异均无统计学意义(P>0.05)。结论:对中重度BPH患者行TURP术前应用非那雄胺3个月以上可显著减少术中、术后出血,而术前应用非那雄胺5～7天不能显著减少术中出血。

Objective： 1o evaluate the ettective course of tinasteride pretreatment in decreasing blood loss associated with transurethral resection of the middle or large size prostate. Methods： A total 211 patients with prostate larger than 40ml scheduled to undergo transurethral resection of the prostate（TURP） for benign prostatic hyperplasia（BPH） were divided into 3 groups. Long-term group of 43 cases were treated for at least 3 months preoperatively with finasteride 5rag daily, Short term group of 90 cases were treated for 5-7 days preoperatively with finasteride 5rag daily, and the last group of 78 cases was set as a control group without any pretreatment. The clinical data during the operation and 1 month after the operation were analysed retrospectively. Results：There were no significant differences between the protate volumes of the 3 groups （ P 〉0.05）. The intraoperative blood loss,the amount of 4% mannitol solution irrigated during TURP, the operating time, and the time and the saline used for bladder infusion postoperatively of the long-term group were significantly less than the control group, and the satisfaction of the operator to the TURP field of the long-term group was significantly better than the control group（P〈0.05）. But no significant differences in the above clinical indexes were noted between the short-term group and the control group（ P 〉0.05） except in the time and the saline used for bladder infusion postoperatively.Conclusions：Long-term finasteride administration before TURP can significantly decrease the intraoperative and postoperative blood loss, and a course of at least 3 months pretreatment is recommended as a kind of preoperative preparation for patients with middle or large size BPH.