非那雄胺对经尿道前列腺切除术中出血和冲洗液吸收影响的定量性研究

Effect of finasteride on intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate: a quantitative study

目的 :探讨术前口服非那雄胺对经尿道前列腺切除术 ( TURP)患者术中出血量和冲洗液吸收量的影响。方法 :将 80例前列腺增生患者随机分为两组 ,对照组 4 0例术前不用非那雄胺 ,试验组 4 0例术前口服非那雄胺 ;应用比色法和庆大霉素标记法定量测定两组患者术中出血量和冲洗液吸收量。结果 :两组术中出血总量、冲洗液血红蛋白浓度、每克切除前列腺组织出血量、每分钟出血量、冲洗液吸收总量、每克切除前列腺组织冲洗液吸收量、每分钟冲洗液吸收量比较 ,实验组明显比对照组减少 ( P<0 .0 5 )。实验组低血压发生率、输血量、手术结束时血钠下降值、低钠血症发生率均较对照组明显减少 ( P<0 .0 5 )。结论 :术前短期服用非那雄胺可以减少 TURP术中出血和冲洗液吸收 ,降低手术并发症。

Objective: To evaluate the effect of pretreatment with finasteride in decreasing intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate (TURP). Methods: Eighty patients with benign prostate hypertrophy undergoing TURP were divided into two groups: 40 patients were pretreated with finasteride for 7 to 14 days before TURP and 40 patients without pretreatment. Absorption of irrigating fluid was quantified by analyzing the serum concentration of gentamycin. Intraoperative blood loss was calculated based on hemoglobin concentrations before and after operation. Results: The whole blood loss, hemoglobin concentration of irrigating fluid used, blood loss per minute, blood loss per gram tissue resected, whole irrigation absorption, irrigation absorption per minute and per gram tissue resected in patients pretreated with finasteride were significantly less than those in patients without pretreatment ( P <0.05). The blood transfusion volume, the incidence of hypotension and hyponatremia in patients pretreated with finasteride were significantly less than those in patients without pretreatment ( P <0.05). Conclusion: Pretreatment with finasteride is of value in reducing intraoperative bleeding, irrigation absorption and perioperative complication during TURP.