【摘要】 目的评价术前应用戈舍瑞林对经尿道前列腺切除术(transurethral resection of prostate,TURP)术中出血量的影响及其作用机理。方法将前列腺增生(benign prostatic hyperplasia,BPH)患者随机分为3组。A组:术前28 d口服非那雄胺(保列治,5 mg/d),B组:术前22 d皮下注射戈舍瑞林3.6 mg,C组:空白对照组。每组30例。比较3组前列腺切除重量、术中出血量,免疫组织化学SP法检测前列腺组织微血管密度(micro vessel density,MVD)及血管内皮生长因子(vascular endothelial growthfactor,VEGF)蛋白表达,统计学分析。结果前列腺组织平均手术切除量比较,3组间差别均无统计学意义,术中平均出血量、平均切除1 g前列腺组织失血量、前列腺组织MVD值、微血管腔内面积、VEGF平均阳性细胞数比较,A组与B组、C组比较,B组与C组比较,差别均有统计学意义(P<0.05)。结论术前应用戈舍瑞林可以抑制前列腺组织内VEGF蛋白表达,进而抑制前列腺组织血管生成,从而减少TURP术中出血,效果比术前口服非那雄胺更佳,无明显副作用。更多还原

【Abstract】 Objective To evaluate the influence and mechanism of preoperative Goserelin on decreasing bleeding during transurethral resection of prostate(TURP).Methods A randomized controlled experiment was carried out.A total of 90 patients with benign prostatic hyperplasia,who were to receive TURP treatment,were divided into three groups(Group A,B and C) with 30 patients in each.Group A received Finasteride for 4 weeks before TURP(5 mg/d),Group B subcutaneous injection of 3.6 mg Goserelin Acetate for 22 days,and Group C was the control group.The weight of removed prostatic tissue and the volume of bleeding of each group were compared.Micro vessel density(MVD) and vascular endothelial growth factor(VEGF) expressions in prostatic tissue were measured with ISH SP-method.Results There was no significant difference in the mean weight of removed prostatic tissue,but there was statistic difference in the mean volume of operative bleeding,bleeding after 1 g prostatic tissue removed,MVD,the area of microvascular cavity,and the mean positive cell count of VEGF(P<0.05).Conclusions VEGF expression and angiogenesis in the prostate tissue are suppressed and blooding during TURP is decreased by the use of preoperative Goserelin,which causes no side effect and therefore is more effective than Finasteride.更多还原