肿瘤基底部麻醉在膀胱肿瘤电切术中的应用.docVIP

精品论文 参考文献 肿瘤基底部麻醉在膀胱肿瘤电切术中的应用 （1滨州医学院\山东省东营市人民医院泌尿外科 山东 烟台 264003） （2山东省东营市人民医院泌尿外科 山东 东营 257091） 【摘要】 目的：研究肿瘤基底部麻醉联合硬膜外阻滞麻醉，在预防经尿道膀胱肿瘤电切术（TURBt）中闭孔神经反射中发生的作用。方法：对我院2007年至2012年收治的104例行TURBt术的患者进行回顾性分析，按照不同的麻醉方式将患者分成3组：A组应用硬膜外阻滞麻醉（42例），B组应用肿瘤基底部局部麻醉联合硬膜外阻滞麻醉（34例），C组为应用闭孔神经阻滞联合硬膜外阻滞麻醉（29例）。对闭孔神经反射发生率、手术时间、术中出血量、留置导尿管时间、术后膀胱冲洗时间、住院时间、并发症发生率等进行统计学分析。结果：A组术中发生闭孔神经反射19例，其中1例出现轻微膀胱穿孔；B、C组术中发生闭孔神经反射各2例。A、B组间及A、C组间差异均有统计学意义（Ple;0.05），B、C组间差异无统计学意义（Pge;0.05）；A、B、C各组在术后膀胱冲洗时间、留置导尿管时间、住院天数、术后半年肿瘤复发率等方面差异均无统计学意义（Pge;0.05）。结论：TURBt术中联合肿瘤基底部浸润麻醉能够有效地抑制闭孔神经反射的发生，同时未增加其它风险的发生率，相较于闭孔神经阻滞麻醉，是一种更加安全的手术方式，值得临床上进行推广。 【关键词】 膀胱肿瘤；经尿道电切术；闭孔神经反射；局部浸润麻醉 【中图分类号】R730.5 【文献标识码】A 【文章编号】2095-1752（2015）36-0090-02 The study of role of local infiltration anesthesia in transurethral resection of bladder tumor WentaoDeng1,Jiru Lu2,Zhi Yuan2,Wei Jiang2,Shaoting Wang2,Ruqiang Zheng1*.(1Binzhou medical university, Yantai, Shandong Province, 264003) (2Peoplersquo;s Hospital of Dongying, Urology Department, Dongying, Shandong Province, 257091) 【Abstract】Objective To explore the effect of local infiltration anesthesia in the bases of the tumors during transurethral resection of bladder tumor (TURBt) in preventing obturator nerve reflex.Methods The clinical data were collected in 104 patients during TURBt from 2007 to 2012. The patients were divided into three groups: A group used epidural anesthesia in 42 cases, B group used local infiltration anesthesia in the bases of the tumors and epidural anesthesia in 34 cases, C group used obturator never block and epidural anesthesia in 34 cases.Then statisticalanalysis was operated to evaluate the incidence rate of obturator nerve reflex, operation time, time of urine retention, time of bladder irrigation, length of stay, and the incidences of complications. Result Theincidence of obturator nerve reflex ofA group was 19, including 1 slight perforation; theincidence of obturator nerve reflex ofB and C group was both 1.