非那雄胺对TURP术中术后出血的影响

Effect of Finasteride on Perioperative and Postoperative Bleeding Following Transurethral Resection of Prostate

目的评价术前术后服用非那雄胺对经尿道前列腺电切除术(transurethral resection of prostate,TURP)术中术后出血的影响。方法176例良性前列腺增生症(benign prostatic hyperplasia,BPH)患者,对于术前7 d及术后30 d服用非那雄胺5 mg的60例患者纳为5 mg组,服用10 mg的60例患者纳为10 mg组,未服用非那雄胺的56例患者纳为未服药组,比较三组TURP术中、术后失血量及术后镜下血尿转阴时间。结果176例TURP术均获得成功。与未服药组比较,服药组的术中冲洗液量、术中失血量、平均切除1 g前列腺组织失血量、术后冲洗时间、术后冲洗液量、术后失血量均显著降低,差异有统计学意义(P<0.05),但是5 mg组与10 mg组差异无统计学意义;术后镜下血尿转阴时间,服药组明显缩短且10 mg组差异有统计学意义(P<0.05)。结论术前应用非那雄胺7 d能够有效减少TURP术中术后失血量;术后应用非那雄胺10 mg/d的能够明显缩短TURP术后镜下血尿阴转时间,减少术后出血。

Objective To evaluate the effect of finasteride on perioperative and postoperative bleeding following transurethral resection of prostate （TURP）. Methods Totally 176 patients with benign prostatic hyperplasia （BPH） were scheduled for TURP, 60 of them were received 5mg of finasteride daily for seven days before surgery and thirty days after surgery, 60 of them were received 10mg of finasteride, the other 56 patients were not received finasteride. A comparative study of clinical data was made among the three groups. Results The operation was successfully completed in 176 cases. As compared to the group without taking finasteride, intraoperative irrigating fluid volume, intraoperative blood loss, blood loss of ] gram prostate tissue for resection, postoperative irrigating time, postoperative irrigating fluid volume, postoperative blood loss in the two groups with taking finasteride were significantly less, the difference had statistical significance （P〈 0.0.5）. But there was no statistically significant difference between the 5mg finasteride group and the 10mg finasteride group. The duration of hematuria associated with TURP was significantly less in 10mg finasteride group （P〈0.05）. Conclusions The use of finasteride before TURP can reduce perioperative and postoperative bleeding. The use of 10mg finasteride after TURP can shorten the duration of hematuria associated with TURP.