【作者】 王锋锋；

【导师】 陈铭；

【作者基本信息】 广州中医药大学 ， 中西医结合临床， 2012， 硕士

【摘要】 目的：评价术前联合应用紫地合剂和非那雄胺对经尿道前列腺等离子电切术(transurethral plasmakinetic vaporization prostatectomy, TUPKP)术中出血的影响。方法：将45例良性前列腺增生症(benign prostatic hyperplasia, BPH)患者按就诊顺序随机分为中西药联合组、西药组及对照组,各组均为15例,中西药联合组于术前7天服用非那雄胺,5mg,Qd和紫地合剂,50ml,Tid,西药组术前仅服用非那雄胺,5mg,Qd。而对照组术前不予服用上述两种药物,均施行TUPKP术。采用高铁血红蛋白试剂法(MetHb)测定术中冲洗液血红蛋白浓度,比较手术时间、术中冲洗量、术中出血量、出血指数、手术效率、术后冲洗量、术后冲洗时间及术后1月镜下血尿转阴情况。结果：三组病例均顺利完成手术,手术过程中无输血,三组术中切除前列腺组织重量比较无明显差异(P>0.05),而中西药联合组在手术时间、术中冲洗量、术中出血量、出血指数及手术效率上较对照组均有显著差异(P<0.05),其手术时间、术中出血量、出血指数及手术效率较西药组同样有显著差异(P’<0.05)。而西药组与对照组相比,仅在术中冲洗量、术中出血量上明显减少(P<0.05),而在手术时间、出血指数和手术效率上均无显著性差异(P>0.05)。三组在术后冲洗量、术后冲洗时间及术后1月镜下血尿情况转阴情况无明显差异(P>0.05)。结论：我院制剂紫地合剂联合非那雄胺能明显减少TUPKP术中出血,提高手术效率,且术后观察与随访并不增加迟发性出血的风险。更多还原

【Abstract】 ObjectiveTo evaluate the effect of Zi Di Mixture and finasteride on intraoperative hemorrhage in patients with benign prostatic hyperplasia (BPH) treated by transurethral plasmakinetic vaporization prostatectomy (TUPKP)Methods45patienis with BPH were randomly and evenly divided into three groups, combined treatment group with Zi Di Mixture and finasteride, finasteride group and control group, and scheduled for TUPKP, patients in combined treatment group were received5mg of finasteride daily and50ml of Zi Di Mixture three times daily for sevendays before surgery, the finasteride group only were received5mg of finasteride for sevenday before surgery, the control group were not given any of above drugs, hemoglobin of intraoperative irrigating fluid were determined by the MetHb method. A serial clinical data of three groups were observed, calculated, recorded and statistically analysed.Resultsall45patienis finished the surgery successfully without transfusion of blood. In addition to no significant difference among weight of removal prostate in three groups, some other difference was discovered. Compared to control group, operate time, intraoperative irrigating fluid volume, amount of intraoperative bleeding, bleeding index in combined treatment group were significantly less (P<0.05),and obtained more operation efficiency (P<0.05). In addition, the significant difference of operate time,amount of intraoperative bleeding, bleeding index and operation efficiency also were observed between combined treatment group and finasteride group(P’<0.05). Yet, there were no significant difference in traoperative irrigating fluid volumeor between them(P>0.05). In finasteride group, only volume of traoperative irrigating fluid and amount of intraoperative bleeding were obvious less than control group (P<0.05).As paused delivery of the two drugs after TUPKP, there were no significant difference in postoperative irrigating time, postoperative irrigating fluid volume and the duration time of hematuria among three groups(P>0.05).ConclusionThe use of Zi Di Mixture and finasterid before TUPKP can reduce perioperative bleeding and increase operation efficiency.It is also no evidence to increase the risk of postoperative delayed bleeding.更多还原