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Objective To explore the value of transesophageal doppler in transurethral resection prostate.Methods Thirty-six patients (aged 60-85 years, falling into ASA grade Ⅰ-Ⅲ) of benign prostatic hyperplasia for undergoing transurethral resection prostate were enrolled.Through multifunction monitor, CVP, Narcotrend index(NI) were monitored before anesthesia induction (T0), 20 minutes after anesthesia induction (T1), after irrigating fluid of 5 000 ml (T2) and 10 000 ml (T3) and 15 000 ml (T4) and 20 000 ml (T5).By transesophageal doppler, FTc(corrected flowtime), SV(stroke volume), ΔPV(peak flow vaviable quantity) were monitored at T1-T5.Results CVP at T1-T5 were not significantly changed compared with that at T0.Compared with T1, FTc, SV at T3-T5were significantly increased and ΔPV at T2-T5were significantly decreased (P<0.05).CVP levels correlated significantly with both FTc (r=0.702, P<0.01) and SV (r=0.595, P<0.01).CVP negatively correlated significantly with ΔPV (r=-0.351, P<0.05).Furthermore, FTc correlated significantly with the concentrationof Na+(r=0.672,P<0.01).No patient had serum sodium ion concentration less than 125 mmol/L.Conclusion FTc of transesophageal doppler is as accurate as central venous pressure in monitoring hemodynamic changes, and even more sensitive than CVP.It is useful in early diagnosis and treatment of TURS.
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Objective To observe analgesia effect of morphine hydrochloride and hydromorphone hydrochloride in patients after transurethral resection of prostate. Methods Patients after transurethral resection of the prostate (TURP) were randomly divided into 2 groups, morphine hydrochloride group (n=45) and hydromorphone hydrochloride group (n=47). Analgesia, sedation efficacy and adverse reactions were evaluated at 6 and 24 h after they received epidural postoperative analgesia by using VAS score and Ramsay score. Results In 6 h, hydromorphone hydrochloride group had a better pain tolerance and feeling than morphine hydrochloride group (P0.05).There were no differences in adverse reactions between the two groups ( P>0. 05 ) . Conclusion Hydromorphone has a better effect than morphine in epidural analgesia in 6 h.
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Objective To explore the clinical effect of suprapubic small cut method combined with transurethral resection prostate(TURP) on the treatment of benign prostatic hyperplasia(BPH) complicated with bladder stones.Methods Sixty patients with BPH complicated with bladder stones ≥ 3 cm in the People's Hospital of Futian Affiliated to Guangdong Medical College from January 2013 to September 2014 were selected as the study group,and another 60 patients with BPH complicated with bladder stones＜3 cm during the same period were selected as the control group.The cases in the study group were treated with suprapubic small cut method combined with TURP,and the cases in control group were treated with transurethral method combined with TURP.The intraoperative indicators (including the time used for crushed stone,total operation time,blood loss,conversion to laparotomy,blood transfusion and bladder perforation),residual bladder stones and complications of postoperative were compared.Results The operations of the two groups of patients were successfully,and there was no conversion to laparotomy and either bladder perforation.The stone removal time and total operative time of patients of the study group were shorter than of the control group,the difference was statistically significant((12.20±3.55) min vs.(24.05±7.68) min,(62.31± 10.49) min vs.(82.46± 16.75)min;t =10.849,7.897;P＜0.001).The intraoperative blood loss and the cases of blood transfusion of patients of the study group were less than the control group,but the prevalence of urinary tract infection were higher(6vs.4),but the difference was not statistically significant(P＞0.05).Residual stones were more commonly in the control group than in the study group (study group:0,control group:6 cases),the difference was statistically significant(x2 =6.316,P=0.012).Conclusion BPH complicated with bladder stones can be treated by the suprapubic small cut method combined with TURP or transurethral method combined with TURP,but suprapubic small cut method combined with TURP is safer and more effective,which is worthy of popularization and application in clinic.
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ObjectiveTo evaluate the efficacy and safety of tolterodine tartrate in treating patients with early overactive bladder(OAB) symptoms after transurethral resection prostate (TURP).Methods Thirty-one patients who received TURP and were found OAB at recent follow-up were enrolled and divided by random digits table method into study group ( 16 cases) and control group ( 15 cases).The patients in study group were treated with 2 mg tolterodine tartrate twice a day for four weeks,while the changes of OAB in control group were observed.The OAB symptoms score (OABSS),maximum flow rate(Qmax),24 h urination and adverse reactions during the period of medication of two groups before and after treatment were recorded and observed.Results The second evaluation,all the indexes except Qmax in study group improved significantly compared with those of the first evaluation in study group and control group the second evaluation.The indexes included urination times[(6.8 ± 1.0) times vs.( 12.5 ± 1.5) times,(11.8 ± 1.2)times],urgency times[(1.4 ± 1.1) times vs.(4.1 ±2.2) times,(4.1 ±2.3) times],urine volume [(214 ±36) ml vs.( 177 ± 46) ml,( 178 ± 44) ml ],nocturia times [ ( 1.9 ± 0.7) times vs.(2.9 ± 1.3 ) times,(2.8 ±1.4) times ],urge incontinence times [ (0.6 ± 0.5 ) times vs.( 1.6 ± 1.0) times,( 1.5 ± 1.0) times ].OABSS in study group the second evaluation was significantly lower than that in the first evaluation in study group and the second evaluation in control group [ (3.6 ± 1.8 ) scores vs.( 7.6 ± 3.3 ) scores,(7.4 ± 3.2) scores,P ＜ 0.01 or ＜ 0.05 ].There was no statistical significance in all the indexes in control group between the first evaluation and the second evaluation (P ＞ 0.05).There were 2 cases with adverse reactions which performed as dry mouth which could be tolerant.ConclusionTolterodine tartrate is efficient and safe in treating patients with early OAB symptoms after TURP.