经尿道膀胱肿瘤切除术中闭孔神经反射的预防探讨.docVIP

精品论文 参考文献 经尿道膀胱肿瘤切除术中闭孔神经反射的预防探讨 [摘 要]目的：分析研究经尿道膀胱肿瘤切除术中闭孔神经反射的预防方法。方法：随机选取2012年5月-2015年5月于本院就诊的80例行经尿道膀胱肿瘤切除术患者作为研究对象，依据数字表法随机分为对照组以及观察组，每组各40例；对照组采取常规硬膜外麻醉＋肌松药＋面罩给氧，观察组患者则采用硬膜外麻醉＋闭孔神经阻滞麻醉。结果：对照组有7例患者出现轻微闭孔神经反射，但未造成膀胱穿孔，3例出现严重闭孔神经反射，其中1例需要进行膀胱修补术。观察组有2例患者出现轻微闭孔神经反射，均未造成膀胱穿孔，两组对比结果显示差异显著，观察组明显优于对照组（P＜0.05）。结论：硬膜外麻醉抑制闭孔神经反射效果较差，肌松药的应用虽可抑制膀胱肌肉收缩，但应严格注意用药剂量以及维持时间。闭孔神经反射较易导致膀胱穿孔，故注意调整手术方法并联合应用硬膜外麻醉以及闭孔神经阻滞麻醉，以此预防闭孔神经发射的发生。 [关键词]经尿道膀胱肿瘤切除术 闭孔神经反射 预防方法 DOI:10.3760/cma.j.issn.0376-2491.2015.44.049 作者单位：3111121，浙江省余杭区，杭州市余杭区第二人民医院 The prevention of urinary bladder tumor resection in patients of obturator nerve reflex Lu Laixing Abstract：Objective: To study the prevention methods of transurethral resection of the bladder tumor in patients with obturator nerve reflex. Methods: randomly selected in May 2012 - 2015 years 5 months in our hospital 80 patients after transurethral resection of the bladder tumor resection patients as the research object, according to the random number table into control group and observation group, each with 40 cases in each; the control group take the routine epidural anesthesia + muscle relaxant + surface cover to oxygen, the patients in the observation group were used epidural anesthesia + obturator nerve block anesthesia. Results: in the control group, 7 patients had slight obturator nerve reflex, but did not cause perforation of the bladder, 3 cases appeared serious obturator nerve reflex, including 1 case of need for repair of bladder. In the observation group, 2 patients had slight obturator nerve reflex, did not lead to perforation of the bladder, compared the two groups results show significant differences in observed group was significantly better than the control group (P lt; 0.05). Conclusion: epidural anesthesia can inhibit the obturator nerve reflex and poor muscle relaxant drug application although inhibition of bladder muscle contraction, but should be strict attention to the dosage and duration. Obturator nerve reflex is ea