超声引导下近端和远端入路闭孔神经阻滞在经尿道膀胱电切术中的比较  

Comparison of ultrasound-guided proximal and distal approach for obturator nerve block in transurethral resection of bladder cancer

作　　者：刘采采 仪福霞 赵学芳[1] 乔梁[2] 纪凡层[1] LIU Caicai;YI Fuxia;ZHAO Xuefang;QIAO Liang;JI Fanceng(Department of Anesthesiology,Weifang People's Hospital,Weifang 261041,China;Department of Urinary Surgery,Weifang People's Hospital)

机构地区：[1]潍坊市人民医院麻醉科,山东潍坊261041 [2]潍坊市人民医院泌尿外科

出　　处：《潍坊医学院学报》2020年第5期372-374,共3页Acta Academiae Medicinae Weifang

基　　金：潍坊市科委基金项目(项目编号:2018YX007)。

摘　　要：目的比较超声引导下近端和远端入路闭孔神经阻滞在经尿道膀胱肿瘤电切术中的有效性。方法选择采用腰麻硬膜外麻醉联合闭孔神经阻滞行经尿道膀胱肿瘤切除术的患者60例,ASA分级Ⅰ~Ⅲ,随机分为两组:近端组(P组):以耻骨肌和闭孔外肌之间的筋膜为靶位,单次注射局麻药完成闭孔神经阻滞;远端组(D组):在闭孔神经前支和后支所在的筋膜内注入局麻药。每组30例。记录神经阻滞操作时间、内收肌痉挛等级、临床有效率、手术时间和并发症等。结果两组闭孔神经阻滞的临床有效率无差异。但近端组无内收肌痉挛的患者例数明显多于远端组(P<0.05)。两组均无并发症出现。结论两组之间临床疗效无差异,近端阻滞可能优于远端阻滞。Objective To compare the effectiveness of ultrasound-guided proximal and distal approach techniques in blocking the obturator nerve during transurethral resection of a bladder tumor.Methods A total of 60 patients with American Society of Anesthesiologists Status Ⅰ to Ⅲ who underwent TURBT under spinal anesthesia were randomly selected and divided into two groups.One group received ultrasound-guided proximal obturator nerve block approach(proximal group),and the other group received ultrasound guided distal obturator nerve block approach(distal group).There were 30 patients in each group.Duration of the procedure,grade of adductor muscle spasm,the rate of clinical effectiveness,operation time and complications were recorded.Results No difference was found in clinical effectiveness rate of obturator nerve block between the two groups.The number of patients who had no adductor muscle spasms in the proximal group was significantly higher than that of the distal group(P<0.05).And no complications were detected in both groups.Conclusion No difference was found for clinical effectiveness between the two groups.The proximal approach may be superior to the distal approach.

关 键 词：超声引导下近端 超声引导下远端 闭孔神经阻滞 经尿道膀胱肿瘤电切术 

分 类 号：R737.14[医药卫生—肿瘤]