论文部分内容阅读
目的:探讨非那雄胺联合盐酸坦索罗辛对前列腺增生症（BPH）患者围手术期腺体微血管密度（MVD）的影响。方法:选取温州市中西医结合医院2017年8月至2019年8月就诊的BPH患者90例为观察对象，采用随机数字表法分为对照组和观察组，每组45例。两组均行经尿道前列腺电切术，对照组围手术期口服盐酸坦索罗辛，观察组口服非那雄胺联合盐酸坦索罗辛，两组服药6周。对比两组临床疗效、不良反应，治疗前后尿动力学指标、腺体微血管密度、国际前列腺症状量表（IPSS）评分、泌尿症状困扰量表（BS）评分、自制血尿色卡评分变化及不良反应发生情况。结果:服药6周后，两组最大尿流率显著高于治疗前，逼尿肌压力、残余尿量较治疗前下降（均n P<0.05）；观察组服药6周后的最大尿流率［（15.63±2.26）mL/s］显著高于对照组［（13.14±2.23）mL/s］，残余尿量［（29.19±4.81）mL］显著低于对照组［（32.25±5.52）mL］（n t=5.26、2.80，均n P < 0.05）。观察组服药6周后的IPSS评分［（12.09±2.17）分］、术后1周血尿色卡评分［（1.51±0.27）分］显著低于对照组［（14.28±2.22）分、（2.03±0.38）分］（ n t=4.73、7.48，均n P < 0.05）。观察组前列腺腺体第Ⅷ因子相关抗原（FⅧ-Rag）、簇分化抗原34（CD34）表达MVD值分别为（14.74±3.05）个/视野、（19.41±3.07）个/视野，显著低于对照组的（18.08±3.16）个/视野、（22.27±3.16）个/视野（ n t=5.10、4.35，均n P < 0.05）。观察组术后血尿发生率［15.56%（7/45）］显著低于对照组［35.56%（16/45）］（χ n 2=4.73，n P < 0.05）。n 结论:与单药治疗相比，BPH围术期给予非那雄胺联合盐酸坦索罗辛治疗，患者尿动力学指标显著改善，前列腺腺体MVD、IPSS评分、血尿色卡评分、血尿发生率均显著降低，为预防BPH患者围术期出血提供了一种新思路。“,”Objective:To investigate the effects of finasteride combined with tamsulosin hydrochloride administered during the perioperative period on glandular microvessel density in patients with benign prostatic hyperplasia.Methods:Ninety patients with benign prostatic hyperplasia who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from August 2017 to August 2019 were included in this study. They were randomly assigned to receive either oral tamsulosin hydrochloride alone (control group, n n = 45) or oral finasteride combined with tamsulosin hydrochloride (observation group, n n = 45) during the perioperative period of transurethral resection of the prostate. All patients received 6 weeks of medication. Clinical efficacy, adverse reactions, and urodynamic indexes, glandular microvessel density, International Prostatism Symptom Score, bother score, and urine color/degree of haematuria score pre- and post-treatment were compared between the two groups.n Results:The maximum urinary flow rate in each group significantly increased 6 weeks after treatment compared with before treatment. The detrusor pressure and residual urine volume in each group decreased 6 weeks after treatment compared with before treatment. After 6 weeks of treatment, the maximum urinary flow rate was significantly higher in the observation group than in the control group [(15.63 ± 2.26) mL/s n vs. (13.14 ± 2.23) mL/s], and residual urine volume was significantly lower in the observation group than in the control group [(29.19 ± 4.81) mL n vs. (32.25 ± 5.52) mL, n t = 5.26, 2.80, both n P < 0.05). International Prostatism Symptom Score measured 6 weeks after treatment and urine color/degree of haematuria score measured 1 week after treatment were (12.09 ± 2.17) points and (1.51 ± 0.27) points, respectively in the observation group, which were significantly lower than those in the control group [(14.28 ± 2.22) points, (2.03 ± 0.38) points, n t = 4.73, 7.48, both n P < 0.05]. Factor VIII related antigen- and CD34-positive glandular microvessel density values in the observation group were (14.74 ± 3.05) counts/visual field and (19.41 ± 3.07) counts/visual field, respectively, which were significantly lower than those in the control group [(18.08 ± 3.16) counts/visual field, (22.27 ± 3.16) counts/visual field, n t = 5.10, 4.35, bothn P < 0.05]. The incidence of postoperative hematuria was significantly lower in the observation group than in the control group [15.56% (7/45) n vs. 35.56% (16/45), n χ2 = 4.73, n P < 0.05].n Conclusion:Compared with tamsulosin hydrochloride alone, finasteride combined with tamsulosin hydrochloride administered during the perioperative stage can greatly improve the urodynamic indexes of patients with benign prostatic hyperplasia, reduce microvessel density value, International Prostatism Symptom Score, bother score, and decrease the incidence of hematuria. The combined therapy provides a novel idea for preventing perioperative bleeding in patients with benign prostatic hyperplasia.