阿司匹林预防前列腺增生急性尿潴留疗效.docVIP

阿司匹林预防前列腺增生急性尿潴留疗效 　 作者：沈文 邓志雄 聂海波 张长征 郭飞 华伟 黄成 【摘要】 目的 观察阿司匹林预防前列腺增生患者急性尿潴留的疗效及安全性，探讨前列腺增生患者发生急性尿潴留的可能原因。方法 随机双盲法选择前列腺增生急性尿潴留高危患者127例，分为阿司匹林治疗组60例及对照组67例。治疗组给予非那雄胺5 mg/d，坦索罗欣0.2 mg/d及阿司匹林肠溶片50 mg/d;对照组不用阿司匹林，其余同治疗组。持续随访1年，记录治疗前后前列腺大小、IPSS评分、最大尿流率、需手术治疗例数、手术治疗患者平均出血量、发生急性尿潴留人次及其他阿司匹林相关严重副作用发生例次。结果 治疗组和对照组治疗后前列腺大小、IPSS评分、最大尿流率比较均无显著差异(均Pgt;0.05)，治疗组中18例(30.0%)接受手术，明显低于对照组32例(47.8%)(Plt;0.05)，接受手术患者术中出血量比较无统计学差异(Pgt;0.05);治疗组患者未发生胃出血、严重出血倾向或哮喘等阿司匹林相关严重副作用;治疗组发生急性尿潴留11例(18.3%)，显著低于对照组23例(34.3%)(Plt;0.05)。结论 阿司匹林预防前列腺增生患者急性尿潴留的发生安全有效，降低了前列腺增生患者手术治疗风险。其可能作用机制是减少了前列腺急性梗塞发生，提示前列腺增生急性尿潴留与前列腺梗塞密切相关。 【关键词】 前列腺增生;急性尿潴留;阿司匹林;梗塞 　　【Abstract】 Objective To observe the efficacy and safty of aspirin in prevention of acuate urine retention(AUR) in patients with benign prostatic hyperplasia(BPH), and to approach the etiology of AUR in patients with BPH. Methods 127 BPH patients with high risk of AUR were doubleblindly randomized into treatment (60 cases) and control groups(67 cases). Patients in treatment group were given 5 mg/d finasteride, 0.2 mg/d tamsulosin and 50 mg/d aspirin, patients in control group were given finasteride and tamsulosin but no aspirin for a year. Volume of prostate, IPSS scores, max urine flow rate, operated cases, cases of AUR, bleeding volume in prostatic operation and severe side effect related aspirin were observed. Results The volume of prostate, IPSS scores and max urine flow rate of patients in treatment group after 1 year were no difference in compare with those in control group(P=0.17, 0.39, 0.21, respectively). There were 18 patients(30.0%) in treatment group underwent operation, which were significantly lower than 32 patients(47.8%) in control group(P=0.041). The volume of bleeding in operation in treatment group were no difference than that of control group(P=0.77). No severe side effect of aspirin such as gastrorrhagia, severe hemorrhagic tendency and asthma had been seen in treatment group. 11 AUR cases(18.3%) happened in treatment group which