非那雄胺对经尿道前列腺等离子电切除术中、术后各项指标的影响

The impact of finasteride on transurethral plasmakinetic resection of prostate patients

目的探讨术前服用非那雄胺对经尿道前列腺等离子电切除术（TUPKVP）患者国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流速（Qmax）、残余尿量（PVR）、术中出血、手术时间、冲洗液量等指标的影响。方法180例前列腺增生症患者随机分为观察组和对照组各90例，观察组和对照组均采用常规治疗，观察组术前1周开始每天服用非那雄胺5mg；对照组术前未服用非那雄胺。术后随访1个月，比较两组TUPKVP患者IPSS、QOL、Qmax、PVR、术中失血量、手术时间、冲洗液量等指标变化。结果治疗后，两组均较治疗前有显著改善（t：5．11、7．01、3．06、6．17、11．82、4．13、4．52、5．17，均P〈0．05）；其中IPSS、Qmax、PVR治疗后观察组显著优于对照组（t=11．35、5．26、3．12，均P〈0．05），QOL治疗后两组差异无统计学意义（P〉0．05）；观察组治愈率87．8％，明显高于对照组（X2=14．56，P〈0．05）；观察组术中出血、手术时间、冲洗液量均优于对照组（t=21．15、43．12、5．33，均P〈0．05），两组住院时间差异无统计学意义（P〉0．05）。结论术前服用非那雄胺能够减少TUPKVP术中出血及冲洗液量，缩短手术时间，有效提高经尿道等离子电切前列腺术的临床效果。

Objective To explore the before taking finasteride on transurethral plasmakinetic resection of prostate（TUPKVP） patients about IPSS, QOL, Qmax, PVR and other indicators. Methods 180 cases with benign prostatic hyperplasia were randomly divided into observation group and control group,90 cases in each group. Observa- tion group and control group were given conventional therapy and the observed patients took 5 mg of finasteride everyday one week before surgery, all patients were followed up for 1 month. The two groups of TUPKVP patients were compared about IPSS, QOL, Qmax and PVR, intraoperative blood loss, operation time, irrigation fluid volume indicators. Results 180 patients were given successfully TUPKVP surgery. IPSS, QOL, Qmax and PVR contrast were significant- ly improved after treatment （t =5.11,7.01,3.06,6.17,11.82,4.13,4.52,5.17 ,all P 〈0.05）. IPSS, Qmax, PVR of the observation group after treatment was significantly better than that of the control group（t = 11.35,5.26,3.12, all P 〈 O. 05 ）, the QOL difference between the two groups after treatment was not statistically significant（ P 〉 0.05 ）. The cure rate of the observation group was 87.8%, which was significantly higher than 63.33% in the control group （ X^2 = 14.56, P 〈 0.05 ）. Intraoperative flushing fluid volume, intraoperative blood loss, duration of surgery in the observation group were significantly different compared with the control group, （ t = 21.15,43.12,5.33, all P 〈 0.05 ）. Conclusion The preoperative taking finasteride can reduce TUPKVP blood loss and flushing fluid volume, shorten operation time and effectively improve the security of the operation.