盐酸坦索罗辛联合非那雄胺在前列腺增生症围术期应用效果
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摘要
目的观察盐酸坦索罗辛与非那雄胺在前列腺增生症(BPH)患者围术期的疗效。方法选择2017年6月—2018年1月行经尿道前列腺电切术(TURP)的BPH 200例的临床资料进行回顾性分析,根据围术期用药方案分为观察组和对照组,每组100例。2组均给予盐酸坦索罗辛,观察组在此基础上给予非那雄胺。观察2组用药前后尿动力检查结果、术中输血及术后血尿情况,比较2组前列腺尿道黏膜上皮血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)阳性细胞表达水平和近期疗效,记录不良反应发生率。结果治疗后,2组最大尿流率及最大逼尿肌压力均较治疗前升高,残余尿量少于治疗前,且观察组优于对照组(P <0. 05)。观察组术后血尿发生率低于对照组(P <0. 05)。观察组前列腺尿道黏膜上皮VEGF阳性细胞数低于对照组,TGF-β1阳性细胞数高于对照组(P <0. 05)。观察组24 h憋尿困难次数、夜尿次数及前列腺症状评分低于对照组(P <0. 05)。2组用药不良反应发生率比较差异无统计学意义(P>0. 05)。结论围术期应用盐酸坦索罗辛联合非那雄胺可降低BPH患者TURP术中出血及术后血尿发生率,改善患者临床症状,安全性高。
Objective To observe efficacy of Tamsulosin Hydrochloride and Finasteride in treatment of patients with benign prostatic hyperplasia( BPH) during preoperative period. Methods Clinical data of 200 patients with BPH undergoing transurethral resection of prostate( TURP) during June 2017 and January 2018 was retrospectively analyzed,and the patients were divided into observation group( n = 100) and control group( n = 100) according to the perioperative medication methods. All patients were treated with Tamsulosin Hydrochloride,and then observation group was added with Finasteride on the basis of Tamsulosin Hydrochloride therapy. In two groups,urinary motility test results before and after treatment and conditions of intraoperative blood transfusion and postoperative hematuria were observed,and vascular endothelial growth factor( VEGF) levels,expressions of transforming growth factor β1( TGFβ1) positive cells in prostatic urethra mucosal epithelium and short-term efficacy were compared,and incidence rates of adverse reactions were recorded. Results After treatment,values of maximum urinary flow and maximum detrusor pressure were significantly increased,while residual urine volume( RUV) was significantly decreased compared with those before treatment in two groups( P < 0. 05),and the indexes in observation group were better than those in control group( P < 0. 05). Incidence rate of postoperative hematuria in observation group was significantly lower than that in control group( P < 0. 05). In observation group,number of VEGF positive cells in prostatic urethra mucosal epithelium was significantly lower,while number of TGF-β1positive cells was significantly higher than those in control group( P < 0. 05). Values of frequencies of24 h dysuria and nocturia and international prostate symptom scores( IPSS) in observation group were significantly lower than those in control group( P < 0. 05). There was no significant difference in incidence rate of drug adverse reaction between two groups( P > 0. 05). Conclusion Tamsulosin Hydrochloride and Finasteride in treatment of BPH patients undergoing TURP during preoperative period may reduce intraoperative blood loss and postoperative incidence rate of hematuria and improve clinical symptoms with good safety.
Objective To observe efficacy of Tamsulosin Hydrochloride and Finasteride in treatment of patients with benign prostatic hyperplasia( BPH) during preoperative period. Methods Clinical data of 200 patients with BPH undergoing transurethral resection of prostate( TURP) during June 2017 and January 2018 was retrospectively analyzed,and the patients were divided into observation group( n = 100) and control group( n = 100) according to the perioperative medication methods. All patients were treated with Tamsulosin Hydrochloride,and then observation group was added with Finasteride on the basis of Tamsulosin Hydrochloride therapy. In two groups,urinary motility test results before and after treatment and conditions of intraoperative blood transfusion and postoperative hematuria were observed,and vascular endothelial growth factor( VEGF) levels,expressions of transforming growth factor β1( TGFβ1) positive cells in prostatic urethra mucosal epithelium and short-term efficacy were compared,and incidence rates of adverse reactions were recorded. Results After treatment,values of maximum urinary flow and maximum detrusor pressure were significantly increased,while residual urine volume( RUV) was significantly decreased compared with those before treatment in two groups( P < 0. 05),and the indexes in observation group were better than those in control group( P < 0. 05). Incidence rate of postoperative hematuria in observation group was significantly lower than that in control group( P < 0. 05). In observation group,number of VEGF positive cells in prostatic urethra mucosal epithelium was significantly lower,while number of TGF-β1positive cells was significantly higher than those in control group( P < 0. 05). Values of frequencies of24 h dysuria and nocturia and international prostate symptom scores( IPSS) in observation group were significantly lower than those in control group( P < 0. 05). There was no significant difference in incidence rate of drug adverse reaction between two groups( P > 0. 05). Conclusion Tamsulosin Hydrochloride and Finasteride in treatment of BPH patients undergoing TURP during preoperative period may reduce intraoperative blood loss and postoperative incidence rate of hematuria and improve clinical symptoms with good safety.
引文
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[9]李杰,余思源.输尿管镜手术围术期应用盐酸坦索罗辛临床价值分析[J].现代仪器与医疗,2018,24(3):38-40.
[10]姚宏涛,薛晓玲.盐酸坦洛新缓释胶囊联合体外冲击波碎石术治疗输尿管下段结石合并前列腺增生效果观察[J].解放军医药杂志,2017,29(8):60-62.
[11]仲晨,文伟,夏术阶.良性前列腺增生症患者药物与微创治疗的经济学和有效性分析[J].中华医学杂志,2016,96(4):289-292.
[12]王悦.围术期精细护理在经尿道前列腺等离子双极汽化电切术老年高危前列腺增生患者中的应用效果观察[J].临床误诊误治,2016,29(10):116-117.
[13]彭涛,庄红雨,许学敏,等.良性前列腺增生症患者经尿道前列腺电切术后服用非那雄胺的临床效果及病症影响因素[J].中国医药,2017,12(11):1735-1739.
[14]杜耀安,陈健.大剂量非那雄胺在前列腺增生术中的临床应用及对MVD、VEGF水平的影响[J].现代中西医结合杂志,2017,26(21):2342-2344.
[15]陈昊,吴晓鸣.血清炎症因子、转化生长因子-β1、前列腺特异抗原及前列腺特异抗原密度在老年前列腺增生患者中的表达及意义[J].中国老年学杂志,2018,38(4):860-861.
[16]杜耀安,陈健.大剂量非那雄胺在前列腺增生术中的临床应用及对MVD、VEGF水平的影响[J].现代中西医结合杂志,2017,26(21):2342-2344.
[17]王春仙,宫香宇,张素英,等.前列欣联合盐酸坦索罗辛和非那雄胺治疗老年良性前列腺增生的疗效观察[J].中国药房,2017,28(8):1108-1111.
[18]沈军,虞晓勇,郭国响,等.非那雄胺的不同用药方式对经尿道前列腺汽化电切除术出血的疗效观察[J].中国医刊,2016,51(1):100-102.
[2]刘勇,张刘璐,江澜,等. 1. 5T MR多序列对前列腺增生与前列腺癌诊断价值[J].中国CT和MRI杂志,2017,15(8):105-108.
[3]侯浩宇,杨保智.前列腺动脉栓塞术、经尿道前列腺电切术及保守治疗良性前列腺增生的近远期疗效比较[J].解放军医药杂志,2016,28(12):91-95.
[4]陈昊.经尿道前列腺等离子电切术联合气压弹道碎石术治疗前列腺增生合并膀胱结石的临床效果分析[J].中国基层医药,2018,25(2):212-216.
[5]那彦群.中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社,2006:67-72.
[6]刘清泉,陈智,周丹青,等.不同止血药物对老年经尿道前列腺电切患者的疗效及安全性分析[J].中华老年医学杂志,2016,35(8):850-853.
[7]沈传运,胡海翔.男性更年期综合征的中医治疗研究进展[J].空军医学杂志,2016,32(3):209-212.
[8]章巧云,熊文清.前列腺增生患者经尿道前列腺电切术后出血96例患者的回顾性分析[J].血栓与止血学,2017,23(2):310-312.
[9]李杰,余思源.输尿管镜手术围术期应用盐酸坦索罗辛临床价值分析[J].现代仪器与医疗,2018,24(3):38-40.
[10]姚宏涛,薛晓玲.盐酸坦洛新缓释胶囊联合体外冲击波碎石术治疗输尿管下段结石合并前列腺增生效果观察[J].解放军医药杂志,2017,29(8):60-62.
[11]仲晨,文伟,夏术阶.良性前列腺增生症患者药物与微创治疗的经济学和有效性分析[J].中华医学杂志,2016,96(4):289-292.
[12]王悦.围术期精细护理在经尿道前列腺等离子双极汽化电切术老年高危前列腺增生患者中的应用效果观察[J].临床误诊误治,2016,29(10):116-117.
[13]彭涛,庄红雨,许学敏,等.良性前列腺增生症患者经尿道前列腺电切术后服用非那雄胺的临床效果及病症影响因素[J].中国医药,2017,12(11):1735-1739.
[14]杜耀安,陈健.大剂量非那雄胺在前列腺增生术中的临床应用及对MVD、VEGF水平的影响[J].现代中西医结合杂志,2017,26(21):2342-2344.
[15]陈昊,吴晓鸣.血清炎症因子、转化生长因子-β1、前列腺特异抗原及前列腺特异抗原密度在老年前列腺增生患者中的表达及意义[J].中国老年学杂志,2018,38(4):860-861.
[16]杜耀安,陈健.大剂量非那雄胺在前列腺增生术中的临床应用及对MVD、VEGF水平的影响[J].现代中西医结合杂志,2017,26(21):2342-2344.
[17]王春仙,宫香宇,张素英,等.前列欣联合盐酸坦索罗辛和非那雄胺治疗老年良性前列腺增生的疗效观察[J].中国药房,2017,28(8):1108-1111.
[18]沈军,虞晓勇,郭国响,等.非那雄胺的不同用药方式对经尿道前列腺汽化电切除术出血的疗效观察[J].中国医刊,2016,51(1):100-102.