两种5α-还原酶抑制剂对经尿道前列腺等离子切除术出血量的影响

江东;黄兴;麦蕾;郭惠学;张荣凯

【期刊名称】《中华腔镜泌尿外科杂志（电子版）》

【年(卷),期】2017(011)003

【摘要】Objective To investigate the effect on blood loss of transurethral plasmakinetic resection of prostate (TUPKP) in treatment of benign prostatic hyperplasia (BPH) by using dutasteride and finasteride perioperatively.Methods In this study,60 patients with confirmed BPH were randomly divided into group A and group B.Patients in group A took dutasteride 0.5 mg orally once a day for one week before operation and one week after operation,patients in group B took fmasteride 10 mg orally once a day for one week before operation and one week after operation.All patients underwent TUPKP by the same surgical team.The changes of prostative volume,prostative peak velocity after medication for one week were observed,intraoperative and postoperative bleeding per gram of excised prostate,lavage fluid volume,operation time and period of microscopic hematuria were compared between the two groups.Results No significant difference was observed in prostative volume of both groups (P＞0.05) and in prostative peak velocity of group B (P＞0.05),but there was significant difference in prostative peak velocity of group A (P＜0.05).There was no significant differences in intraoperative and postoperative bleeding per gram of excised prostate,lavage fluid volume and operation time between the two groups (P＞0.05),but there was significant differences in period of microscopic hematuria between the two groups (P＜0.05).Conclusion Using dutasteride and finasteride perioperatively can reduce the blood loss during and after operation of TUPKP,and dutasteride takes effect faster and results in shorter period of microscopic hematuria.%目的 探讨围手术期口服度他雄胺及非那雄胺对行经尿道前列腺等离子切除术的良性前列腺增生患者术中术后出血量的影响.方法 本研究将确诊的60例前列腺增生患者随机分成A、B两组.A组术前及术后均口服度他雄胺1周,每日1次,每次0.5 mg;B组术前及术后均口服非那雄胺1周,每日1次,每次10 mg.患者均经同一手术组医师使用等离子电切镜进行手术.对两组患者用药1周后前列腺体积、最大血流速度变化及两组患者平均切除每克前列腺的术中出血量、手术时间、术中术后膀胱冲洗液量、镜下血尿时间进行比较.结果 两组患者术前用药1周后前列腺体积变化均无统计学意义(P＞0.05),A组用药1周后最大血流速度下降有统计学意义(P＜0.05),B组用药1周后最大血流速度下降无统计学意义(P＞0.05).A组和B组在平均切除每克前列腺的术中出血量、手术时间、术中术后膀胱冲洗液量差异无统计学意义(P＞0.05),A组镜下血尿时间短于B组,差异有统计学意义(P＜0.05).结论 围手术期应用度他雄胺及非那雄胺均可减少前列腺增生患者术中及术后的出血量,度他雄胺术前起效更快且术后镜下血尿时间更短.