非那雄胺和立止血联合用于经尿道前列腺电切术的临床观察

Clinical Observation of Combination Regimen of Finasteride and Reptilase in Transurethral Resection of Prostate

目的评价术前服用非那雄胺和术中使用立止血对经尿道前列腺切除术(TURP)术的影响。方法采用随机对照试验,将拟行TURP术的BPH患者随机分为A组术前非那雄胺组(5mg/d×2w)、B组术中立止血组(1kuiv+1kuim)、C组术前非那雄胺联合术中立止血组及D组对照组,每组30例。记录各组TURP前列腺切除重量、术中失血量,电切操作时间,以及术后连续膀胱冲洗时间,并进行统计学分析。结果A、B、C、D组前列腺组织平均手术切除量分别为(19.4±7.9)g、(20.3±8.)6g、(19.3±6.7)g、(21.2±5.4)g,统计学分析四组之间无显著差异(P>0.05)。术中平均出血量分别为(170.5±86.4)mL、(163.4±73.4)mL、(137.0±68.2)mL、(245.1±168.9)mL,术后连续膀胱冲洗时间平均为(49.4±10.5)h、(51.9±14.6)h、(41.4±9.5)h、(52.7±16.9)h,经统计学分析,A组、B组在术中平均出血量上没有差异(P>0.05),都与D组有显著性差异(P<0.05),而在术后连续膀胱冲洗时间上,A组与B组存在差异(P<0.05),但B组与D组没有差异(P>0.05);对于这两个方面,C组与另三组均有显著性差异(P<0.05)。电切操作时间分别为(67.2±19.5)min、(66.8±25.8)min、(65.5±20.9)min、(83.5±20.3)min,A、B、C组间无明显差异,但都与D组有统计学意义。结论术前服用非那雄胺联合术中使用立止血可减少TURP术中术后出血,缩短手术时间和术后冲洗时间。

Objective To evaluate the effects of preoperative use of finasteride and intraoperative use of reptilase in transurethral resection of prostate（TURP）. Methods A randomized controlled trial was conducted. A total 120 patients with benign prostatic hyperplasia, who would be given TURP treatment,were divided into four groups（Group A, B, C and D） with 30 patients for each. Group A was given finasteride pretreatment for two weeks（5mg/d × 2w）, Group B was given intraoperative reptilase（lku iv＋1ku im）, Group C was given both finasteride pretreatment for two weeks and intraoperative reptilase, and Group D was used as control group. The clinical results were recorded and analyzed statistically. Results The resection volume of prostate was（ 19.4 ±7.9）g in Group A, （20.3 ±8.6）g in Group B, （ 19.3 ±6.7）g in Group C and （21.2 ±5.4）g in Group D, respectively, with no significant differences among them（P 〉 0.05 ）. The intraoperative blood loss was （ 170.5 ±86.4）mL, （ 163.4 ± 73.4）mL, （ 137.0 ±68.2）mL and（245.1 ±168.9）mL,respectively and postoperative bladder infusion was（49.4 ±10.5）h, （51.9 ±14.6）h, （41.4 ±9.5）h and （52.7 ±16.9 ）h , respectively. There was no significant difference in intraoperative blood loss between Group A and Group B（P〉 0.05）,but both differed in it from Group D（P〈 0.05）; There was a significant difference between Group A and Group B（P 〈 0.05 ） in postoperative bladder douche, but no difference between Group B and Group D（P 〉 0.05 ）;Group C differed significantly from other three groups in both intraoperative blood loss and postoperative bladder douche （P〈 0.05）.The operating time of four groups was （67.2±19.5）rain in Group A, （66.8±25.8）rain in Group B,（65.5±20.9）min in Group C and （83.5±20.3）min in Group D, with no difference among the first three groups but significant difference between the first three groups and Group D. Conclusion Combination regimen of preoperative use of finasteride and intraoperative use of reptilase in TURP can significantly decrease the intraoperative and postoperative blood loss and also shorten the operating time and postoperative bladder douche.