前瞻随机对照研究:新技术对硬性膀胱镜患者舒适度的提高  

A prospective randomized control study:new rigid cystoscopy technology to improve patients' comfort

作　　者：姚林[1] 张雷[1] 范宇[1] 张政[1] 徐燕鹏[1] 刘茗洁 何志嵩[1] 龚侃[1] 李学松[1] 张争[1] 张崔健[1] 周利群[1] 

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿,男性生殖系肿瘤研究中心

出　　处：《北京大学学报（医学版）》2014年第4期635-637,共3页Journal of Peking University:Health Sciences

摘　　要：目的：评价行硬性膀胱镜检查时使用“IUPU （Institute of Urology,Peking University,北京大学泌尿研究所）操作法”能否提高男性患者舒适度.方法：378名拟行硬性膀胱镜的男性患者随机分至IUPU操作法组（n=193）及常规操作法组（n=185）,所有患者在检查前经阴茎挤入10 mL盐酸奥布卡因凝胶.IUPU操作法组的操作方法为请护士在镜鞘及闭孔器通过尿道膜部前挤压盐水袋,而常规操作法组则直接将镜鞘及闭孔器经尿道置入膀胱.操作结束之后,所有患者立刻在10点视觉模拟评分表上打分.结果：IUPU操作法组患者疼痛评分为2（1～2）分,而常规操作法组为4（3 ～6）分,两组间差异具有统计学意义（P ＜0.001）.初次做膀胱镜、既往做过膀胱镜及膀胱镜复查患者均得到了同样的结果（P值均＜0.001）.结论：对硬性膀胱镜操作进行简单的改良操作可以显著提高患者的舒适度,建议对需要行膀胱镜操作的男性患者使用IUPU操作法.Objective ： To determine whether the extruded irrigation solution bag during passage of rigid cystoscope will reduce the patient＇ s discomfort. Methods： In the study, 378 male patients undergoing rigid cystoscopies were randomized into ＂Institute of Urology Peking University （IUPU） ＂ technique group （n = 193 ） and routine manipulation group （n = 185 ）. All the patients had received 10 mL oxybupro- caine gel before manipulation. In the IUPU technique group, irrigation solution bag was connected with cystoscope sheath and obturator. As the scope passed through the bulbar urethra, a nurse was instructed to extrude the irrigating fluid bag. A 10-point visual analog pain scale assessment was completed by the patient after the procedure. Results： The visual analog pain score was 2 （ 1 - 2） in the IUPU technique group and 4 （3 -6） in the routine manipulation group （P 〈0.001, Mann-Whitney U test）. All the pro- cedure indications had no effect on the findings. Conclusion： This study has shown that a simple IUPU technique can significantly reduce the patient＇ s discomfort during outpatient rigid cystoscopy. We strong- ly recommend this technique for all male patients undergoing rigid cystoscopy.

关 键 词：膀胱镜检查 前瞻性研究 男性 

分 类 号：R615[医药卫生—外科学]