硬膜外自控镇痛泵防治前列腺术后膀胱痉挛失败原因分析

摘要

目的：观察硬膜外自控镇痛泵（PCEA）防治前列腺术后膀胱痉挛的失败原因，探讨补救措施。方法总结10年来PCEA防治前列腺术后膀胱痉挛的临床资料，分析PCEA防治前列腺术后膀胱痉挛的失败原因。结果本组11例，2例自控泵电源不足，3例硬膜外导管滑脱，1例导管阻塞，1例接头漏液，3例麻药配方剂量不足，1例硬膜外腔粘连。以上问题出现分别予以更换电池、静脉自控泵镇痛、更换三通管接头和应用盐酸屈他维林以补救。11例均达到防治膀胱痉挛的满意效果，未出现严重血尿和术后切口感染等严重并发症。结论 PCEA防治前列腺术后膀胱痉挛效果肯定，一旦发现术后镇痛效果不佳，及时分析原因，并予以纠正或采取其他方法防止膀胱痉挛，以免引起出血、感染等严重并发症。%Objective To investigate the failure causes and remedial measures of bladder spasm of patient-controlled epidural analgesia pump treatment after prostatectomy. Methods Clinical data of patient who received controlled epidural analgesia pump treatment of bladder spasm after prostatectomy in last ten years were summarized and reviewed retrospectively, andthe failure causes for bladder spasm of patient-controlled epidural analgesia pump treatment after prostatectomy were analzed. Results The group of 11 cases, 2 cases of controlled pump power supply, 3 cases of epidural catheter slippage, catheter obstruction in 1 cases, 1 cases of joint leakage, 3 cases of deficiency of anesthetic dose formula, 1 cases of epidural adhesion. All of the above problems are to replace the battery, patient-controlled intravenous analgesia, joint replacement and application of three pipe Drotaverine to remedy. All 11 cases achieved satisfactory effect in the prevention of bladder spasm, no severe hematuria and serious complication after incision infection. Conclusion Sure of bladder spasm after prostatectomy PCEA prevention effect, once found the postoperative analgesia effect is poor, timely analysis of the causes, and corrected or adopt other methods to prevent bladder spasm, so as not to cause serious complications of bleeding, infection and so on.