目的 术前短期大剂量应用非那雄胺对经尿道前列腺电切术围术期出血情况的影响.方法 对2015年6月～2016年12月武汉大学人民医院泌尿外科收治的拟行经尿道前列腺等离子电切术120例患者根据术前临床资料进行分组研究,随机分为三组:对照组(未服用任何药物)、10 mg组(术前2周每日口服非那雄胺10 mg)、20 mg(术前2周每日口服非那雄胺20 mg),每组40例.所有患者均由同一术者实施手术,分别记录三组患者手术时间、术中出血量、出血指数、出血强度、术后冲洗液量、术后冲洗时间、术后国际前列腺症状评分(IPSS)、术后最大尿流率以及切除前列腺组织重量,并进行统计学分析比较.结果 所有患者均顺利完成手术,三组患者在切除前列腺组织重量、术后IPSS评分及术后最大尿流率等方面,差异无统计学意义(P＞0.05);相较于对照组,10 mg及20 mg两组在手术时间、术中出血量、出血指数、出血强度、术后冲洗液体量以及术后冲洗时间等方面显著降低,差异有统计学意义(P＜0.05).相较于10 mg组,20 mg组在手术时间、术中失血量、出血指数、出血强度、术后冲洗时间等方面显著降低,差异有统计学意义(P＜0.05),而在术后冲洗液量方面,两组差异无统计学意义(P＞0.05).结论 术前短期大剂量口服非那雄胺(20 mg/d)能够有效减少经尿道前列腺电切术围术期出血,缩短手术时间、减少术后膀胱冲洗液量.%Objective To evaluate the effect of preoperative short-term high-dose application of Finasteride on perioper ative bleeding of transurethral resection of prostate.Methods From June 2015 to December 2016,120 patients with benign prostatic hyperplasia (BPH) treated at Renming Hospital of Wuhan University were selected.According to the preoperative clinical data,the total of 120 patients were randomly divided into three groups and the amount of every group was 40.The 10 mg group and 20 mg group respectively took 10 mg and 20 mg of Finasteride daily for two weeks and the control group did not take any durg before the operation.All the operations were finished by the same surgeon and the results of operation time,intraoperative blood loss,amount of bleeding index,the strength of bleeding,postoperative blad der lavage fluid volume and time,postoperative international prostate symptom score (IPSS),flow rate of the maximum urinary and the weight of removed prostatic tissue should be collected in statistical analysis and comparison.Results All operations were successfully and the three groups of patients had no difference among the aspects of postoperative IPSS,flow rate of the maximum urinary and the weight of removed prostatic tissue (P ＞ 0.05).Compared with the control group,both the 10 mg and 20 mg groups had statistically significant differences in the aspects of operation time,intraoperative blood loss,amount of bleeding index,the strength of bleeding,postoperative bladder lavage fluid volume and time (P ＜ 0.05).Compared with 10 mg group,the 20 mg group in the aspects of operation time,intraoperative blood loss,bleeding index,the strength of bleeding and postoperative bladder lavage time decreased significantly with statistical differences (P ＜0.05),and there was no significant difference between the two groups in the aspect of postoperative bladder lavage fluidvolume (P ＞ 0.05).Conclusion The preoperative shortterm usage of large doses Finasteride (20 mg/d) can effectively reduce perioperative bleeding,the time of operation and postoperative bladder lavage fluid volume.
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