神经刺激仪定位闭孔神经阻滞在经尿道膀胱肿瘤电切术中的应用  

Application of nerve stimulator for obturator nerve block in transurethral resection of bladder tumor

作　　者：王帅彬[1] 顾腾飞 包云帆 何有华[1] 

机构地区：[1]温州医科大学附属第二医院泌尿外科,325027

出　　处：《中华全科医师杂志》2016年第1期56-58,共3页Chinese Journal of General Practitioners

摘　　要：回顾性分析我院120例行经尿道膀胱肿瘤电切术（TURBt）治疗膀胱侧壁肿瘤的患者临床资料，术前利用神经刺激仪对闭孔神经进行定位和阻滞的阻滞组（46例）闭孔神经反射发生率和膀胱穿孔率（7％和0），低于未阻滞组（74例）的（35％和19％）（P=0．002）；手术时间和术后持续生理盐水膀胱冲洗时间为（32．2±12．5）min和（8．9±6．4）h，短于未阻滞组的（43．2±24．5）min和（13．3±10．8）h（P=0．013）；手术效率值（5．8±3．9）min／cm2优于未阻滞组（9．3±7．0）min／cm2（P=0．001）。神经刺激仪定位下行闭孔神经阻滞可提高TURBt手术的安全性和效率。Clinical data of 120 patients undergoing transurethral resection of the bladder sidewall tumors （TURBt） were retrospectively analyzed. Before TURBt the obturator nerve was blocked under the guide of the nerve stimulator in 46 cases （block group）and not blocked in 74 cases （unbloek group）. The incidence of obturator nerve reflex and bladder perforation in block group was significantly lower than that in unblock group（7% vs. 35% , P =0.000 and 0 vs. 19% , P =0.002, respectively）. The operation time and the duration of bladder continuous saline irrigation after operation in block group were shorter than those in unblockedgroup [（32.2±12.5） vs. （43.2±24.5） rain, P=0. 001 and （8.9±6.4） vs. （13.3±10. 8） h, P =0. 013, respectively] . The efficiency value of TURBt in block group was better than that in unblock group [ （5.8 ±3.9） vs. （9.3 ± 7. O） min/cm2, P =0. 001 ] . The obturator nerve block guided by the nerve stimulator can improve the safety and the efficiency of TURBt.

关 键 词：膀胱肿瘤 闭孔神经 

分 类 号：R737.14[医药卫生—肿瘤]