外源性雌孕激素对人子宫内膜异位症裸鼠模型早期病灶中MMP1和TIMP1表达的影响.docVIP

外源性雌孕激素对人子宫内膜异位症裸鼠模型早期病灶中MMP1和TIMP1表达的影响 作者：史文光 单位：胜利石油管理局河口医院 【摘要】 目的 比较亚甲蓝前列腺包膜外注射联合持续硬膜外镇痛与单纯硬膜外镇痛在前列腺切除术后的镇痛效果。方法 选择60例前列腺增生症（BPH）病人，随机分为两组，每组30例，均于连续硬膜外麻醉下行开放前列腺切除术，术后均留置硬膜外管72 h。除亚甲蓝前列腺包膜外注射外，两组麻醉方法及术后镇痛用药均一致。观察两组VAS评分，膀胱痉挛次数、持续时间及恢复情况。结果 亚甲蓝注射组术后镇痛优良率高于单纯硬膜外镇痛组，膀胱痉挛次数少、持续时间短；两组术后恢复情况无明显差异。结论 前列腺术后亚甲蓝包膜外注射联合持续硬膜外镇痛明显优于单纯硬膜外镇痛。 【关键词】 前列腺增生 经尿道前列腺切除术 亚甲蓝 A COMPARISON OF DIFFERENT ANALGESIA AFTER PROSTATECTOMYSHI WENGUANG, CAI BO, LIU WEI, et al(Department of Surgery, Hekou Hospital of Shengli Oil Field, Dongying 257200, China) ［ABSTRACT］ObjectiveTo compare the painrelieve between continuous epidural anesthesia alone and combined injection of methylene blue into extracapsula of the prostate with epidural anesthesia.MethodsPatients with BPH (n=60) undergoing open prostatectomy under epidural anesthesia were evenly divided into two groups. An indwelling epidural tube was remained in place for 72 hours postoperalively. The anesthesia and postoperative analgesia were the same between the two groups besides methylene blue injection mentioned above in another group.VAS score including the frequency, duration and recovery of bladder spasm was recorded.ResultsPatients treated with combined analgesia experienced less bladder spasm, but no significant difference in postoperative course between the two groups.ConclusionCombined injection of methylene blue into extracapsula of the prostate with continuous epidural anesthesia produces better analgesia than continuous epidural anesthesia alone. ［KEY WORDS］prostatic hyperplasia; transurethral resection of prostate; methylene blue 前列腺增生症（BPH）病人行前列腺切除术后疼痛，特别是膀胱痉挛性疼痛，不仅给病人带来巨大痛苦，而且影响预后。临床上镇痛方法较多，但效果不一。有研究报道，亚甲蓝与局麻药物合用硬膜外或局部神经阻滞，术后镇痛效果好，持续时间长，但用于前列腺包膜外注射尚未见报道。本研究对亚甲蓝前列腺包膜外注射联合硬膜外持续镇痛与硬膜外持续镇痛进行观察比较，为临床合理选择术后镇痛方法提供依据。 1 资料与方法 1.1 一般资料 BPH病人60例，年龄55～72岁，平均65岁。随机分为亚甲蓝前列腺包膜外注射联合硬膜外镇痛组（A组，30例）和硬膜外镇痛组（B组，30例）。两组病人在年龄、并发症等方面比较差异均无显著性。 1.2 方法 两组病人均行开放前列腺切除术，耻骨上经膀胱或耻骨后入路，连续硬膜外麻醉。两组均留置硬膜外管72 h。A组术中前列腺增生部切除后，缝扎前列腺动脉，于包膜外自3点至9点钟间注射体积分