腫瘤基底部麻醉在膀胱腫瘤電切術(shù)中的應(yīng)用

《腫瘤基底部麻醉在膀胱腫瘤電切術(shù)中的應(yīng)用》由會員上傳分享，免費在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫。

1、腫瘤基底部麻醉在膀胱腫瘤電切術(shù)中的應(yīng)用(1濱州醫(yī)學(xué)院山東省東營市人民醫(yī)院泌尿外科山東煙臺264003)(2山東省東營市人民醫(yī)院泌尿外科山東東營257091)【摘要】目的：研究腫瘤基底部麻醉聯(lián)合硬膜外阻滯麻醉，在預(yù)防經(jīng)尿道膀胱腫瘤電切術(shù)(TURBt)中閉孔神經(jīng)反射中發(fā)生的作用。方法：對我院2007年至2012年收治的104例行TURBt術(shù)的患者進(jìn)行回顧性分析，按照不同的麻醉方式將患者分成3組：A組應(yīng)用硬膜外阻滯麻醉(42例)，B組應(yīng)用腫瘤基底部局部麻醉聯(lián)合硬膜外阻滯麻醉(34例)，C組為應(yīng)用閉孔神經(jīng)阻滯聯(lián)合硬膜外阻滯麻醉(29例)。對閉孔神經(jīng)反射

2、發(fā)生率、手術(shù)時間、術(shù)中出血量、留置導(dǎo)尿管時間、術(shù)后膀胱沖洗時間、住院時間、并發(fā)癥發(fā)生率等進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:A組術(shù)中發(fā)生閉孔神經(jīng)反射19例，其中1例出現(xiàn)輕微膀胱穿孔；B、C組術(shù)中發(fā)牛閉孔神經(jīng)反射各2例。A、B組間及A、C組間差異均有統(tǒng)計學(xué)意義(P≤0.05),B、C組間差異無統(tǒng)計學(xué)意義(P≥0.05)；A、B、C各組在術(shù)后膀胱沖洗時間、留置導(dǎo)尿管時間、住院天數(shù)、術(shù)后半年腫瘤復(fù)發(fā)率等方面差異均無統(tǒng)計學(xué)意義(P≥0.05)o結(jié)論：TURBt術(shù)中聯(lián)合腫瘤基底部浸潤麻醉能夠有效地抑制閉孔神經(jīng)反射的發(fā)牛，同時未增加其它風(fēng)險的發(fā)牛率，相較

3、于閉孔神經(jīng)阻滯麻醉，是一種更加安全的手術(shù)方式，值得臨床上進(jìn)行推廣。【關(guān)鍵詞】膀胱腫瘤；經(jīng)尿道電切術(shù)；閉孔神經(jīng)反射；局部浸潤麻醉【中圖分類號】R730.5【文獻(xiàn)標(biāo)識碼】A【文章編號】2095-1752(2015)36-0090-02ThestudyofroleoflocalinfiltrationanesthesiaintransurethralresectionofbladdertumorWentaoDengl,JiruLu2,ZhiYuan2,WeiJiang2,ShaotingWang2,RuqiangZhengl*.(lBinzhoumed

4、icaluniversity,Yantai,ShandongProvince,264003)(2People’sHospitalofDongying,UrologyDepartment,Dongying,ShandongProvince,257091)【AbstractlObjectiveToexploretheeffectoflocalinfiltrationanesthesiainthebasesofthetumorsduringtransurethralresectionofbladdertumor(TURBt)inpreven

5、tingobturatornervereflex.MethodsTheclinicaldatawerecollectedin104patientsduringTURBtfrom2007to2012?Thepatientsweredividedintothreegroups:Agroupusedepiduralanesthesiain42cases,Bgroupusedlocalinfiltrationanesthesiainthebasesofthetumorsandepiduralanesthesiain34cases,Cgroupusedob

6、turatorneverblockandepiduralanesthesiain34cases.Thenstatisticalanalysiswasoperatedtoevaluatetheincideneerateofobturatornervereflex,operationtime,timeofurineretention,timeofbladderirrigat:ion,lengthofstay,andtheincidencesofcomplications.ResultTheincideneeofobturatornervereflex

7、ofAgroupwas19,including1slightperforation;theincideneeofobturatornervereflexofBandCgroupwasboth1?ThediffereneebetweenAandBgroup,AandCgroupwerebothstatisticallysign訐icant,meanwhiletherewasnostatisticallysignificaneebetweenBandCgroup.Thediffereneeoftimeofurineretention,timeofbl

8、adderirrigation,andthelengthofstaybetweenA,BandCgroupwerenotstatisti