盐酸坦索罗辛在TURP围手术期的应用价值初探

Preliminary study of perioperational tamsulosin application in transurethral resection of prostate

目的 :探讨盐酸坦索罗辛在经尿道前列腺电切 (TURP)围手术期的应用价值。方法 :5 7例接受TURP手术治疗的良性前列腺增生患者分用药组 (2 5例 )与对照组 (32例 )。用药组围手术期服用盐酸坦索罗辛 ,对照组则不用 ;比较两组术后留置尿管时间、一次拔管成功率、最大尿流率、国际前列腺症状评分 (IPSS)、生活质量评分 (QOL)。结果 :用药组一次拔管成功率 92 % ,术后留置尿管天数 3～ 7(4.9± 1.4 )d ,术前IPSS评分 15～ 32(2 4 .1± 4 .9)分 ,术后下降 8～ 2 5 (17.4± 4 .2 )分 ,QOL评分术前 3～ 6 (4.5± 0 .8)分 ,术后下降 0～ 5 (2 .4± 1.2 )分 ,MFR 10～ 2 1(14 .9± 2 .9)ml/s ;对照组一次拔管成功率 75 % ,术后留置尿管天数 1～ 14 (6 .2± 2 .8)d ,术前IPSS评分 16～ 36 (2 4 .6± 5 .0 )分 ,术后下降 8～ 2 1(15 .0± 4 .4 )分 ,术前QOL评分 3～ 6 (4.7± 0 .8)分 ,术后下降 0～ 4 (1.9± 1.1)分 ,MFR 7～ 2 0 (12 .5± 2 .8)ml/s。统计分析显示两组间留置尿管天数、术后IPSS、QOL评分、MFR下降分值差异有显著性意义 (P <0 .0 5 ) ,一次拔管成功率与术后QOL下降分值差异无显著性意义。结论 :TURP围手术期应用坦索罗辛 ,可有效缩短术后留置尿管时间 ,改善术后早期下尿路症状 。

Purpose:To evaluate the clinical significance of perioperational tamsulosin application in transurethral resection of prostate(TURP).Methods:Fifty seven patients with benign prostate hyperplasia who would accept TURP were divided into two groups obeying perioperational tamsulosin taking or not. Postoperational indwelling duration of urinary catheter, once extubation ratio,peak flow, IPSS and QOL scores were compared in these two groups.Results:The tamsulosin-taking group had a once extubation ratio of 92%, postoperational urinary catheter indwelling duration of 4.9± 1.4 days(3～7days), IPSS of 24.1± 4.9(15～32), IPSS reduction of 17.4± 4.2(8～25),QOL score of 4.5± 0.8(3～6), QOL score reduction of 2.4± 1.2(0～5), peak flow of 14.9± 2.9 ml/s(10～21ml/s). While the control group were 75%, 6.2± 2.8 days(1～14 days), 24.6± 5.0(16～36), 15.0± 4.4(8～21), 4.7± 0.8(3～6), 1.9± 1.1(0～4)and 2.5± 2.8 ml/s(7～20 ml/s)respectively. Significant differences were found in postoperational urinary catheter Indwelling duration, IPSS and IPSS reduction, QOL score, peak flow(P< 0.05), but not in once extubation ratio and QOL score reduction.Conclusions:Perioperational tamsulosin application in TURP could decrease the postoperational indwelling duration of urinary catheter, reduce the pain caused by lower urinary symptoms effectively, and make patients a better life.