术前服用非那雄胺对前列腺电切术后出血的影响研究

Effect of finasteride on bleeding after prostatectomy

目的分析术前服用非那雄胺对于前列腺电切手术术后出血的影响。方法选取2016年1月至2018年1月在本院收治的良性前列腺增生并行经尿道前列腺电切术(TVRP)治疗的患者110例,将其随机分为观察组和对照组,各55例,其中观察组在术前一周开始每日服用非那雄胺5 mg,对照组未服用非那雄胺。比较两组患者一般资料、术中出血量、术后失血量、术后镜下血尿转阴时间以及术后相关免疫组化治疗检测结果。结果 110例患者均手术成功,无电切综合征及死亡病例,两组患者切除前列腺重量比较,差异无统计学意义(P>0.05),与对照组相比,观察组患者的术中出血量、手术时间、术后冲洗时间、术后冲洗液量及术后失血量均明显减少,差异有统计学意义(P<0.05)。观察组患者术后4、5、6周的镜下血尿转阴率均明显高于对照组,差异有统计学意义(P<0.05)。观察组的微血管密度(MVD)水平明显低于对照组,B淋巴细胞瘤-2基因(Bcl-2)、增殖细胞核抗原(PCNA)、血管内皮生长因子(VEGF)阳性细胞面积均小于对照组(P<0.01)。结论术前短期常规服用非那雄胺,能够减少TVRP术中及术后出血并缩短手术时间,值得临床推广。

Objective To analyze the effect of finasteride on perioperative bleeding after pros-tatectomy.Methods A total of 110 patients with benign prostatic hyperplasia(BPH)treated in our hospital were enrolled.The patients were randomly divided into observation group and control group,55 cases in each group.The observation group took finasteride daily before and 30 days after surgery,5 mg,and the control group did not take finasteride.The general data,intraoperative and postoperative hemorrhage,postoperative microscopic hematuria time and postoperative immunohistochemical treatment were compared between the two groups.Results All the 110 patients were successfully operated with-out TURP syndrome and death.There was no significant difference in IPSS,age,and prostate weight be-tween the two groups(P>0.05).Compared with the control group,the amount of bleeding,operation time,postoperative irrigation time,postoperative flushing volume and postoperative blood loss of the observation group were significantly reduced,and the difference was statistically significant between the groups(P<0.05).The microscopic hematuria conversion rate of the observation group was significantly higher than that of the control group at 4,5,and 6 weeks after operation.The difference between the two groups was statistically significant(P<0.05).The MVD level in the observation group was significantly lower than that in the control group,and the area of Bcl-2,PCNA and VEGF positive cells was smaller than that of the control group(P>0.001).Conclusions The short-term routine use of finasteride before surgery can reduce intraoperative and postoperative bleeding and shorten the operation time,which is worthy of clinical promotion.