非那雄胺在经尿道前列腺双极等离子剜除术围手术期的临床应用

The clinical application of finasteride in pert-operation of transurethral plasmakinetic enucleation of prostate

目的探讨非那雄胺对经尿道前列腺双极等离子剜除术患者围手术期出血的影响。方法将前列腺增生患者150例随机分为3组，对照组：50例，未服用非那雄胺；治疗1组：50例，非那雄胺5mg，1次/d，术前、术后均应用7d；治疗2组：50例，非那雄胺5mg，2次/d，术前、术后均应用7d；3组患者均采用经尿道前列腺双极等离子剜除术，比较各组患者术中出血量、手术时间、术中冲洗液量、每克切除前列腺组织出血量、每分钟出血量、术后冲洗时间、术后冲洗液量及3个月内再出血就诊率。结果150例患者均顺利完成经尿道前列腺双极等离子剜除术。与对照组比较，治疗1组和治疗2组的术中出血量、手术时间、术中冲洗液量、每克切除前列腺组织出血量、术后冲洗时间及术后冲洗液量均显著减少（P〈0．05）；每分钟出血量3组分别为（1.77±0．89）ml，／min、（1．71±0．82）ml／min和（1.70±0．81）ml／min，差异尤统计学意义（P〉0．05）。治疗1组和治疗2组的术中出血量、手术时间、术中冲洗液量、每克切除前列腺组织出血量、每分钟出血量、术后冲洗时间、术后冲洗液量比较，差异无统计学意义（均P〉0．05）。术后3个月内再出血就诊率治疗1组（8／35）和治疗2组（3／26）与对照组（17／39）比较，明显减少（χ^2=3．544、7．523，P=0．016、0．025），治疗2组明显少于治疗1组（χ^2=1.293，P=0.044）。结论经尿道前列腺双极等离子剜除术围手术期服用非那雄胺能够减少出向。

Objective To investigate the effect of finasteride on hemorrhage in pert-operation of transurethral plasmakinetic enucleation of prostate （TUPKEP）. Methods 150 patients with benign prostatic hyperplasia （BPH） were randomly divided into 3 groups： control group without finasteride （n 50）, treatment groupl 1 with finasteride 5 mg daily for 7 days（n=50） and treatment group 2 with finasteride 10 mg daily for 7 days（n=50） before and after operation. All patients received TUPKEP and the data were recorded, including total blood loss, operation time, amount of washing fluid during operation, blood loss of per gram tissue, blood loss per minute, washing time after operation, amount of washing fluid after operation, and rebleeding rate within 3 months after operation. Results The 150 patients successfully received TUPKEP. The total blood loss, amount of washing fluid during operation, operation time, blood loss per gram tissue, amount of washing fluid after operation, washing time after operation and rebleeding rate within 3 months after operation in treatment group 1 and 2 significantly reduced as compared with control group （P〈0. 05）. The blood loss per minute were （1.77±0.89 ） ml/min, （1.71± 0.82） ml/min and （1.70± 0.81） ml/min in 3 groups, respectively, and there were no significant differences among groups （P〈0.05）. There were no significant differences between treatment group 1 and 2 in the total blood loss, operation time, amount of washing fluid during operation, blood loss of per gram tissue, blood loss per minute, washing time and amount of washing fluid after operation （P〉0.05）. The rebleeding rate within 3 months after operation in treatment group 1 （8/35） and treatment group 2 （3/26） decreased as compared with control group （17/39） （χ^2=3.544 and 7.523,P =0.016 and 0.025）and it was lower in treatment group 2 than in treatment group 1 （χ^2 = 1. 293, P = 0. 044） . Conclusions The application of finasteride in peri-operation of TUPKEP can reduce hemorrhage.