术前服用非那雄胺对减少钬激光前列腺剜除术中出血作用

Effect of finasteride on reducing hemorrhage in holmium lasterenucleation of prostate

目的评价经尿道钬激光前列腺剜除术（HoLEP）治疗良性前列腺增生（BPH）术前口服非那雄胺对减少术中出血量的影响。方法回顾性分析我院泌尿外科2010年9月至2012年3月156例BPH患者，其中术前口服非那雄胺5mg/d的79例为实验组，术前未服用非那雄胺77例患者为对照组，比较两组患者行HoLEP的手术时间、术中冲洗液、术前及术后血红蛋白含量的变化及术后冲洗时间。结果实验组术中冲洗液量（27．5±3．7）L、术前术后血红蛋白差值（1．1±0．3）g/L及术后冲洗时间（24．9±4．2）h与对照组术中冲洗液量（36．9±6．5）I。术前术后血红蛋白差值（1．6±0．3）g/L及术后冲洗时间（35．9±5．1）h比较均显著降低，差异均有统计学意义（均P〈O．05）。结论术前口服非那雄胺能显著减少HoLEP术的术中出血量，减少术后冲洗液用量。

Objective To evaluate the effect of preoperative oral finasteride on patients with benign prostate hyperplasia （BPH） undergoing holmium [asterenucleation of prostate （HoLEP）. Methods A total of 156 BPH patients from Department of Urology in Shanghai Ninth People＇s Hospital from Sep. 2010 to Mar. 2012 was analyzed retrospectively. 79 patients receiving oral 5 mg/d finasteride before operation were selected as medication group, and the 77 patients without taking finasteride were selected as control group. The perioperative data, including operation time, amount of washing fluid during operation, preoperative and postoperative changes of hemoglobin level and postoperative bladder washing time were compared between two groups. Results Compared with control group, the changes of hemoglobin level after HoLEP, amount of washing fluid during operation, and postoperative bladder washing time with normal saline were significantly decreased in experimental group[（1.08±0.27） g/L vs. （1.55±0.32） g/L, （27.51±3.67） L vs. （36.89±6.47） L, （24.85±4.17） h vs. （35.87-＋5.10） h, all P〈0.05]. Conclusions Oral finasteride before HoLEP can reduce perioperative bleedin~ and the volume of bladder irrigation with normal saline.