CAJ | 학술논문

目的探讨术前服用非那雄胺对经尿道前列腺等离子切除术(PKRP)中出血量的影响. 方法将符合入选标准的118例前列腺增生患者分为安慰剂对照组40例、服药1周组(非那雄胺5 mg/d,术前服用1周)40例和服药3个月组(非那雄胺5 mg/d,术前服用3个月)38例.3组均行PKRP,对3组患者年龄、前列腺体积、国际前列腺症状评分(IPSS)、术中切除的前列腺质量、术中出血量、术中冲洗液量、手术时间、平均切除1g前列腺组织失血量进行比较. 结果 118例患者均顺利完成PKRP.与对照组比较,服药1周组和服药3个月组在年龄、前列腺体积、IPSS、术中切除的前列腺质量方面差异无统计学意义(P＞0.05),但术中失血量[(173.5±16.9)ml、(163.5±15.8)ml和(156.4±16.2) ml]、平均切除1g前列腺组织失血量[(8.6±4.8)ml/g、(7.4±5.4) ml/g和(6.6±5.6)ml/g]、手术时间[(72.5±16.2)min、(58.4±17.8)min和(56.7±16.5) min]、术中冲洗液量[(31.5±5.6)L、(26.4±6.2)L和(24.3±5.2)L]均显著降低,差异有统计学意义(P＜0.05)；服药3个月组与服药1周组比较,在术中失血量、平均切除1g前列腺组织失血量、手术时间、术中冲洗液量均显著降低,差异有统计学意义(P＜0.05). 结论术前服用非那雄胺能有效减少PKRP术中失血量,术前服用非那雄胺3个月以上者减少术中出血的疗效优于术前服用1周者.
목적 탐토술전복용비나웅알대경뇨도전렬선등리자절제술(PKRP)중출혈량적영향. 방법 장부합입선표준적118례전렬선증생환자분위안위제대조조40례、복약1주조(비나웅알5 mg/d,술전복용1주)40례화복약3개월조(비나웅알5 mg/d,술전복용3개월)38례.3조균행PKRP,대3조환자년령、전렬선체적、국제전렬선증상평분(IPSS)、술중절제적전렬선질량、술중출혈량、술중충세액량、수술시간、평균절제1g전렬선조직실혈량진행비교. 결과 118례환자균순리완성PKRP.여대조조비교,복약1주조화복약3개월조재년령、전렬선체적、IPSS、술중절제적전렬선질량방면차이무통계학의의(P＞0.05),단술중실혈량[(173.5±16.9)ml、(163.5±15.8)ml화(156.4±16.2) ml]、평균절제1g전렬선조직실혈량[(8.6±4.8)ml/g、(7.4±5.4) ml/g화(6.6±5.6)ml/g]、수술시간[(72.5±16.2)min、(58.4±17.8)min화(56.7±16.5) min]、술중충세액량[(31.5±5.6)L、(26.4±6.2)L화(24.3±5.2)L]균현저강저,차이유통계학의의(P＜0.05)；복약3개월조여복약1주조비교,재술중실혈량、평균절제1g전렬선조직실혈량、수술시간、술중충세액량균현저강저,차이유통계학의의(P＜0.05). 결론 술전복용비나웅알능유효감소PKRP술중실혈량,술전복용비나웅알3개월이상자감소술중출혈적료효우우술전복용1주자.
Objective To evaluate the effect of finasteride on perioperative bleeding following transurethral plasmakinetic resection of prostate (PKRP).Methods A total of 118 patients with benign prostatic hyperplasia (BPH) undergoing PKRP were randomly divided into three groups:40cases received 5mg of finasteride daily for 7 days before surgery as 1 week group,38 cases received 5mg of finasteride daily for 3 months before surgery as 3 months group,the other 40 cases without taking finasteride before surgery as control group.A comparative study of clinical data was made among the three groups.Results The operation was successfully completed in 118 cases.As compared to control group,intraoperative irrigating fluid volume[(31.5 ± 5.6) L vs.(26.4 ± 6.2) L and (24.3±5.2)L],intraoperative blood loss[(173.5± 16.9) ml vs.(163.5± 15.8) ml and (156.4±16.2) ml],loss of 1 gram prostate tissue for resection[(8.6±4.8)ml/g vs.(7.4±5.4) ml/g and (6.6±5.6) ml/g]and operation time(72.5±16.2) min vs.(58.4±17.8) min and (56.7±16.5) min in 1 week and 3 months groups with taking finasteride were decreased (all P＜0.05).And there were differences in the above indexes (all P＜ 0.05) between 1 week group and 3 months groups.Conclusions The use of finasteride before PKRP is safe and reliable to reduce perioperative bleeding in BPH patients.Moreover,taking 5mg of finasteride for three months is of better effectiveness than taking 5mg of finasteride for 1 week.