超声引导下闭孔神经阻滞在经尿道膀胱肿瘤电切术中的应用

摘要

Objective To study the effectiveness of ultrasound-guided obturator nerve block technique in transurethral resection of the bladder tumor. Methods 60 patients with 57 males and 3 females aged 48 ~ 82 weighting 46~80kg who underwent transurethral electric excision of bladder tumor in our hospital from February, 2014 to November, 2015 were randomly divided into ultrasound-guided group (D group) and control group(C group), 30 cases each group. Two groups of patients were treated with conventional care monitoring SBp, DBp, HR, SpO2 , debug anesthesia plane well after taking the right decubitus for subarachnoid anesthesia, group D was in ultrasound-guided obturator nerve block, observed transurethral time, incidence of obturator nerve reflex and bladder perforation in transurethral electric excision.Results Compared with group C, transurethral time in group D operation was shortened, the operation was carried out smoothly. The incidence of obturator nerve reflex and bladder perforation were significantly lower(P<0.05). Conclusions Ultrasound-guided obturator nerve block can prevent the occurrence of obturator nerve reflex during transurethral resection of bladder tumors safely and effectively.%目的：研究超声引导下行闭孔神经阻滞预防经尿道膀胱肿瘤电切手术中闭孔神经反射的临床效果。方法选取2014年2月至2015年11月期间在本院择期行经尿道膀胱肿瘤电切手术的患者60例,男57例,女3例,年龄48~82岁,体重46~80 kg,随机分成超声引导神经阻滞组(D 组)和对照组(C组),每组各30例。两组患者入室后均常规监护监测 SBp、DBp、HR、SpO2,取右侧卧位行蛛网膜下腔麻醉顺利成功后调试好麻醉平面,D 组在超声引导下行闭孔神经阻滞,观察术中电切时间、闭孔神经反射发生率、膀胱穿孔发生率。结果与 C 组比较,D 组的手术中电切时间相对缩短,手术进行的比较顺利。闭孔神经反射发生率和膀胱穿孔率明显降低(P<0.05)。结论超声引导下闭孔神经阻滞可以安全有效的预防经尿道膀胱肿瘤电切术中的闭孔神经反射。