膀胱灌注辣椒辣素联合术后患者自控硬膜外镇痛防治前列腺术后不稳定膀胱  

The prevention and treatment of unstable bladder after suprapubic prostatectomy by capsaicin in stilled into the bladder combined with patlent-controlled epidural analgesia

作　　者：井汉国[1] 石汝骥[1] 程镇[1] 闫会秋[1] 王腾春[1] 井玉生[1] 霍立志[1] 周玉霞[1] 

机构地区：[1]聊城市第二人民医院泌尿外科,山东临清252600

出　　处：《中国医师进修杂志（外科版）》2008年第8期24-26,共3页Chinese Journal of Postgraduates of Medicine

基　　金：山东省聊城市卫生局医学科研项目（200620）

摘　　要：目的探讨良性前列腺增生（BPH）患者术前膀胱灌注辣椒辣素联合术后患者自控硬膜外镇痛（PCEA）防治开放性前列腺切除术后不稳定膀胱（USB）的效果。方法选择诊断为BPH，拟在硬膜外麻醉下行开放性前列腺切除术的患者60例，随机分为试验组和对照组。试验组30例，术前用100μmol／L辣椒辣素100ml灌注膀胱，保留30min后排空，并术后给予PCEA；对照组30例，仅术后给予PCEA；观察两组术后USB发生情况。结果试验组术后发生USB3例（ ）10．0％；对照组发生USB12例（40．0％），两组比较差异有统计学意义（P〈0．05）。两组均未见明显不良反应发生。结论术前膀胱灌注辣椒辣素联合术后PCEA防治开放性前列腺切除术后USB效果确切，可推广应用。Objective To explore the effect of the prevention and treatment of unstable bladder after suprapubic prostatectomy by capsaicin instilled into the bladder preoperatively combined with patient-controlled epidural analgesia（PCEA）for benign prostatic hyperplasia（BPH）. Methods Sixty patients with BPH underwent suprapubic prostatectomy under epidural anesthesia were randomly divided into control group（30 cases）and treatment group（30 cases）, 100 ml of 100 p. mol/L capsaicin was instilled into the bladder preoperatively for 30 minutes combined with PCEA after operation in treatment group, the control group was only given PCEA. Observed the incidence and continuous time of unstable bladder after operation in two groups. Results Unstable bladder was found in 3 cases of treatment group and they were Ⅰ degree, 12 cases happened unstable bladder in control group,3 cases Ⅰ degree, 5 cases Ⅱ degree, 3 cases Ⅲ degree, 1 case Ⅳ degree. There was obvious significance between two groups （P 〈 0.05）. Conclusion Capsaicin instilled into the bladder combined with PCEA can cut off the reflex arc of detrusor contraction more completely and has obvious effect of decrease the incidence of unstable bladder after suprapubic prostatectomy and can be used widely.

关 键 词：膀胱 过度活动性 辣椒辣素 镇痛 患者控制 前列腺增生 

分 类 号：R614.4[医药卫生—麻醉学] R694[医药卫生—外科学]