CAJ | 학술논문

目的：探索有效的短程抗雄激素疗法以减少经尿道前列腺电切(TURP)手术出血。方法：将177例拟行TURP的良性前列腺增生(BPH)患者随机分为4组，非那雄胺组46例，术前5～7天每天服用非那雄胺5mg；比卡鲁胺组42例，术前5～7天每天服用比卡鲁胺50mg；联合用药组44例，术前5～7天每天服用非那雄胺5mg及比卡鲁胺50mg；对照组45例，未服用任何抗雄激素药物。详细记录患者术中和术后1月期间的临床资料。结果：所有患者服药期间均未发生药物不良反应。比卡鲁胺组和联合用药组TURP术中出血量、4％甘露醇的灌洗液量、电切操作时间、术者对术中视野的满意度、术中是否需要提高灌瓶高度、以及术后生理盐水连续冲洗膀胱的时间和所消耗的冲洗液量与非那雄胺组和对照组分别比较，差异多有统计学意义；而比卡鲁胺组与联合用药组、非那雄胺组与对照组比较，差异均无统计学意义。结论：TURP术前短程服用比卡鲁胺可显著减少术中出血，缩短手术时间和术后膀胱冲洗时间，可作为BPH患者术前准备的方法之一。
목적：탐색유효적단정항웅격소요법이감소경뇨도전렬선전절(TURP)수술출혈。방법：장177례의행TURP적량성전렬선증생(BPH)환자수궤분위4조，비나웅알조46례，술전5～7천매천복용비나웅알5mg；비잡로알조42례，술전5～7천매천복용비잡로알50mg；연합용약조44례，술전5～7천매천복용비나웅알5mg급비잡로알50mg；대조조45례，미복용임하항웅격소약물。상세기록환자술중화술후1월기간적림상자료。결과：소유환자복약기간균미발생약물불량반응。비잡로알조화연합용약조TURP술중출혈량、4％감로순적관세액량、전절조작시간、술자대술중시야적만의도、술중시부수요제고관병고도、이급술후생리염수련속충세방광적시간화소소모적충세액량여비나웅알조화대조조분별비교，차이다유통계학의의；이비잡로알조여연합용약조、비나웅알조여대조조비교，차이균무통계학의의。결론：TURP술전단정복용비잡로알가현저감소술중출혈，축단수술시간화술후방광충세시간，가작위BPH환자술전준비적방법지일。
Objective To search an efficacious short-term anti-androgen scheme to decrease the blood loss in transurethral resection of the prostate(TURP). Methods A total 177 patients with benign prostatic hyperplasia(BPH) scheduled to undergo TURP were randomly allocated to 4 groups. 46 cases of the finasteride group were treated for 5-7 days preoperatively with 5mg finasteride daily, 42 cases of the bicalutamide group were treated for 5-7 days preoperatively with 50mg bicalutamide daily, 44 cases of the combination group were treated for 5-7 days preoperatively with both 5mg finasteride and 50mg bicalutamide daily, and 45 cases of the control group had no above drugs received. The clinical data during the operation and 1 month after the operation and the adverse events related with the drugs were recorded for each patient. Results No adverse reactions related with finasteride or bicalutamide were noted in all of the patients. The blood loss, the 4%mannitol solution used, the operating time, the satisfaction of the operator to the operating field, the need to heighten the perfusion apparatus to obtain a clear field during TURP, and the time and the saline used for bladder infusion postoperatively of the bicalutamide group and the combination group had statistical differences with the finasteride group and the control group. But no significant differences were found between the bicalutamide group and the combination group and between the finasteride group and the control group. Conclusion Oral administration of bicalutamide for 5-7 days before TURP can significantly decrease the intraoperative blood loss, and shorten the time of TURP and postoperative bladder infusion. Short-term bicalutamide administration is recommended as a kind of preoperative preparation for BPH patients.