一种新型导管在减轻男性膀胱尿道镜检查时疼痛中的应用  

Application of a new type of catheter on relieving pain during male cystourethroscopy

作　　者：赵涛[1] 刘家骥[1] 熊永江 张翾[1] ZHAO Tao;LIU Jiaji;XIONG Yongjiang;ZHANG Xuan(Department of Urology,Yongchuan Hospital of Chongqing Medical University,Chongqing,402160,China)

机构地区：[1]重庆医科大学附属永川医院泌尿外科,重庆402160

出　　处：《临床泌尿外科杂志》2018年第12期992-994,999,共4页Journal of Clinical Urology

基　　金：重庆市卫生计生委科研计划项目(编号2016MSXM055)

摘　　要：目的:研究一种新型导管在男性膀胱尿道镜检查时尿道表面麻醉中的有效性和安全性。方法:将220例男性患者随机分成试验组和对照组。试验组患者经该新型导管将1%利多卡因溶液注入后尿道,对照组患者经尿道口注入利多卡因凝胶。采用视觉模拟评分法(VAS)评估两组患者在经尿道给药/插管时(T1)、膀胱尿道镜置入时(T2)、膀胱尿道镜检查开始时(T3)、膀胱尿道镜检查持续3min时(T4)和操作结束后首次排尿时(T5)的疼痛程度,以及检查过程中的最大疼痛程度。监测记录两组患者检查前后及检查过程中血压、心率的波动变化。计算两组患者所需的麻醉费用。结果:试验组除在T1时VAS评分稍高于对照组外(P>0.05),在T2、T3和T4时点的VAS评分均低于对照组(P<0.05);两组患者检查前后血压变化率差异无统计学意义(P>0.05);试验组心率变化率低于对照组,差异有统计学意义[(18.3±1.9)%vs.(24.6±3.0)%,P<0.05]。两组患者均无明显并发症发生。试验组平均每例患者麻醉费用低于对照组(10.5元vs.22.0元,P<0.05)。结论:这种新型导管应用于男性尿道表面麻醉时安全、有效,可明显降低膀胱尿道镜检查时的疼痛,且费用低廉,操作简便,值得在广大基层医疗单位推广应用。Objective:To study the efficacy and safety of a new type of catheter applied to urethral surface anesthesia during male cystourethroscopy,and explore the prospects of the application of the catheter and the anesthetic method in hospitals at primary levels.Method:Two hundred and twenty male patients were randomly divided into the experimental group and the control group.In the experimental group,1% lidocaine solution was irrigated into the posterior urethra using the new type of catheter,while the control group was administered with lidocaine gel.Both groups were assessed by visual analogue scale(VAS)with their pain perceived during transurethral gel injection/intubation(T1),during insertion of the cystourethroscope(T2),at the beginning of cystourethroscopy(T3),3 minutes after the beginning of inspection(T4),during first urination after the inspection(T5),as well with the maximum pain perceived during the whole procedure.The fluctuations in blood pressure and heart rate of each group before,after and during the procedure were recorded,and the anesthesia cost in both groups were calculated.Result:Except for a slightly higher score in T1,the scores of VAS in experimental group were lower than those of control group in T2,T3 and T4.There was no significant difference in blood pressure variation in both groups.The maximum heart rate variation in experimental group is(18.3±1.9)%,which is lower than(24.6±3.0)%in control group.No obvious complications were found in both groups.The anesthesia cost for the experimental group is about 10.5 yuan,which is 12 yuan lower than that of the control group.Conclusion:It is effective and safe to apply the new type of catheter during male urethral anesthesia.It can significantly relieve the pain during male cystourethroscopy,and is low in cost and easy in operation.Thus this method is worth recommending in hospitals at primary levels.

关 键 词：膀胱尿道镜检查 男性 导管 尿道表面麻醉 

分 类 号：R694[医药卫生—泌尿科学]