【摘要】 目的探讨氟他胺在中重度良性前列腺增生(BPH)经尿道前列腺电切术(TURP)治疗前的应用价值。方法48例前列腺体积>40 m l的BPH患者行TURP术前5~7 d给予氟他胺250 mg,每天3次,详细记录患者术中和术后1个月期间的临床资料,并与同期62例未服用抗雄激素药物的BPH手术患者资料进行对比分析。结果治疗组和对照组患者前列腺体积分别为(70.9±24.8)m l和(67.8±27.8)m l,差异无统计学意义(P>0.05),术中出血量分别为(94.4±51.6)m l和(155.8±84.3)m l,甘露醇灌洗液量分别为(18.4±6.2)L和(25.4±8.8)L,电切操作时间分别为(65.0±16.4)m in和(86.8±25.0)m in,术后膀胱冲洗时间分别为(46.5±9.1)h和(57.8±17.4)h,冲洗液量分别为(19.2±4.2)L和(26.7±10.2)L,术中视野满意或较满意分别为36例(75.0%)和26例(41.9%),术中需要增加灌洗压力分别为11例(22.9%)和28例(45.2%),输血分别为3例(6.2%)和14例(22.6%),术后继发性出血分别为5例(10.4%)和16例(25.8%),差异均有统计学意义(P<0.05)。结论TURP术前短程应用氟他胺可显著减少术中、术后出血,可作为中重度BPH患者术前准备的一种方法。更多还原

【Abstract】 Objective To evaluate the clinical efficacy of flutamide administration before transurethral resection of the middle-or large-sized hyperplastic prostate.Methods A total of 110 patients with prostate larger than 40ml scheduled to undergo transurethral resection of the prostate(TURP) for benign prostatic hyperplasia(BPH) were divided into 2 groups.Group A(n=48) were treated with flutamide at 250 mg 3 times daily for 5-7 d preoperatively,and Group B(n=62) without any anti-androgen drug use served as controls.The clinical data during the operation and 1 month after the operation were recorded and compared between the 2 groups.Results No adverse reactions related to flutamide were noted in all of the patients.The preoperative prostate volumes of groups A and B were(70.9±24.8)ml and(67.8±27.8)ml,respectively,with no significant difference between them(P>0.05).In groups A and B,the intraoperative blood loss was(94.4±51.6)ml and(155.8±84.3)ml;the 4% mannitol solution used for intraoperative irrigation was(18.4±6.2)L and(25.4±8.8)L;the operative time was(65.0±16.4)min and((86.8±)25.0)min;the time for postoperative bladder infusion was(46.5±9.1)h and(57.8±17.4)h;the infused saline volume was(19.2±4.2)L and(26.7±10.2)L;the degree of satisfaction of the surgeons with the TURP field was 75.0%(36/48) and 41.9%(26/62);the cases who needed to increase the perfusion pressure during TURP accounted for 22.9%(11/48) and 45.2%(28/62);the blood transfusion rates were 6.2%(3/48) and 22.6%(14/62);and the incidence rates of secondary prostatic bleeding were(10.4)%(5/48) and 25.8%(16/62),respectively.The differences in all these parameters were statistically significant between the 2 groups(P<0.05 for all).Conclusions Short-term flutamide use before TURP can significantly decrease the intraoperative and postoperative blood loss and can be recommended as a premedication for patients with middle-or large-sized BPH.更多还原