神經(jīng)刺激器引導(dǎo)下閉孔神經(jīng)阻滯在膀胱側(cè)壁腫瘤電切術(shù)中的應(yīng)用

《神經(jīng)刺激器引導(dǎo)下閉孔神經(jīng)阻滯在膀胱側(cè)壁腫瘤電切術(shù)中的應(yīng)用》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫。

1、南開大學(xué)碩士學(xué)位論文神經(jīng)刺激器引導(dǎo)下閉孔神經(jīng)阻滯在膀胱側(cè)壁腫瘤電切術(shù)中的應(yīng)用姓名：李偉偉申請(qǐng)學(xué)位級(jí)別：碩士專業(yè)：臨床醫(yī)學(xué)指導(dǎo)教師：張旭2012-05摘要目的：回顧性分析中國人民解放軍總醫(yī)院自2010年9月至2012年3月的膀胱側(cè)壁腫瘤患者的病例資料，通過分析患者分別采用不同的手術(shù)方式其手術(shù)過程來評(píng)估手術(shù)效果，探討利用神經(jīng)刺激器行閉-tLi*經(jīng)阻滯在膀胱側(cè)壁腫瘤電切中的應(yīng)用效果，同時(shí)簡單的探討聯(lián)合應(yīng)用經(jīng)尿道膀胱腫瘤電切術(shù)和激光汽化切除術(shù)其手術(shù)效果。方法：膀胱側(cè)壁腫瘤49例，隨機(jī)分為治療組18例(利用神

2、經(jīng)刺激器作閉孔神經(jīng)阻滯后行經(jīng)尿道膀胱腫瘤電切術(shù))、對(duì)照組21例(直接行經(jīng)尿道膀胱腫瘤電切術(shù)，不作閉孔神經(jīng)阻滯)和實(shí)驗(yàn)組10例(聯(lián)合應(yīng)用經(jīng)尿道膀胱腫瘤電切術(shù)和激光汽化切除術(shù))，三組之間相互比較手術(shù)時(shí)間及術(shù)中出現(xiàn)閉孑L神經(jīng)反射情況。結(jié)果：治療組和實(shí)驗(yàn)組中無一例出現(xiàn)閉孔神經(jīng)反射，對(duì)照組21例中出現(xiàn)5例明顯的閉孔神經(jīng)反射。治療組與對(duì)照組、治療組與實(shí)驗(yàn)組、實(shí)驗(yàn)組與對(duì)照組手術(shù)時(shí)間比較均無顯著差異(P>O．05)，但是治療組中單發(fā)腫瘤12例與對(duì)照組中15例手術(shù)時(shí)問對(duì)比差異顯著(P=O．009<0．05)．結(jié)論：利

3、用神經(jīng)刺激器引導(dǎo)行閉孔神經(jīng)阻滯，則可以準(zhǔn)確的定位閉孔神經(jīng)，提高閉孔神經(jīng)阻滯的成功率，同時(shí)可以縮短手術(shù)時(shí)間；術(shù)中出現(xiàn)閉孔神經(jīng)反射后，可通過降低電切功率或者換用激光汽化切除繼續(xù)完成手術(shù)；聯(lián)合應(yīng)用經(jīng)尿道膀胱腫瘤電切術(shù)和激光汽化切除術(shù)不會(huì)出現(xiàn)閉孔神經(jīng)反射，可以作為淺表性膀胱側(cè)壁腫瘤的一種手術(shù)治療方法。關(guān)鍵詞：膀胱腫瘤，經(jīng)尿道膀胱腫瘤電切術(shù)，神經(jīng)刺激器，閉孔神經(jīng)阻滯Abstract———————————————————————————————————————————————————一一一objective：R

4、etrospectiveanalysisofclinicaldataofthebladdersidewallcancerpatientswhichcomefromGeneralHospitalofPLAsinceSeptember2010toMarch2012．Assessingtheeffectofsurgerybyanalyzingthepatients’OperationProcesswithusingadifferentsurgicalapproach．Discussingtheresult

5、sofcarryingoutobturatornerveblockwiththehelpofthenervestimulatorintransurethralresectionofbladdersidewalltumor．meanwhilesimplydiscussingtheresultsofoperationbycombiningtransurethralresectionofbladdertumorwithlaservaporizationresection．Methods：49casesof

6、thebladdersidewalltumorswererandomlydividedintothreegroups，18casesintreatmentgroupwithobturatornerveblockbythenervestimulatorintransurethralresectionofbladdertumor,21casesincontrolgroupwithoutobturatornerveblockintransurethralresectionofbladdertumor,10

7、casesinexperimentalgroupwithcombiningtransurethralresectionofbladdertumorwithlaservaporizationresection．Theoperativetimeandintraoperativeobturatornervereflexwerecomparedbetweentwoofthreegroups．Results：Nopatientappearedobturatornervereflexinthetreatment

8、groupandexperimentalgroup，andfivecasesappearedobturatornervereflexinthecontr01group．Theoperativetimewasnosignificantdifference(P>O．05)betweentwoofthreegroups．Buttheoperativetimeofsolitarytumorwassignificantdifference(P==0．009<0．05、betwe