B超引导下闭孔神经阻滞在经尿道膀胱肿瘤电切术中的应用  

Application of Obturator Nerve Block Guided by B-ultrasound in Transurethral Resection of Bladder Tumors

作　　者：何灵生 黄富群 何志龙 赖少峰 孙毅敏 王建宇 梁峰 HE Lingsheng;HUANG Fuqun;HE Zhilong;LAI Shaofeng;SUN Yimin;WANG Jianyu;LIANG Feng(Fenggang Hospital,Dongguan City,Dongguan 523690,China;不详)

机构地区：[1]东莞市凤岗医院,广东东莞523690

出　　处：《中外医学研究》2021年第31期22-25,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：东莞市科技计划项目(202050715034611)。

摘　　要：目的:探讨B超引导下闭孔神经阻滞在经尿道膀胱肿瘤电切术中的应用。方法:选取本院2020年4月-2021年8月收治的40例行尿道膀胱肿瘤电切术患者,按照随机数字表法分为对照组(n=20,给予椎管内麻醉)和观察组(n=20,给予B超引导下闭孔神经阻滞麻醉),观察两组患者临床指标、各时段生命体征及血流动力学情况。结果:观察组出血量少,手术时间短,闭孔神经反射发生率、膀胱穿孔发生率、术后膀胱穿孔修补率低于对照组(P<0.05);两组患者T_(0)时MAP、HR差异均无统计学意义(P>0.05),T_(1)、T_(2)时,两组MAP、HR均降低,但观察组高于对照组(P<0.05);麻醉后,两组每搏输出量、心脏指数均降低,但观察组高于对照组(P<0.05)。结论:B超引导下闭孔神经阻滞应用于经尿道膀胱肿瘤电切术治疗可提高临床各项指标,减少术后膀胱穿孔修补率的发生,对生命体征影响较小,血流动力学水平稳定。Objective:To explore the application of obturator nerve block guided by B-ultrasound in transurethral resection of bladder tumor.Method:From April 2020 to August 2021,40 patients with urethral and bladder tumor were randomly divided into control group(n=20,given intraspinal anesthesia)and observation group(n=20,given obturator nerve block anesthesia under B-ultrasound guidance).The clinical indexes,vital signs in different time and hemodynamics of the two groups were observed.Result:The blood loss was less,time of surgery was shorter,the incidence of obturator nerve reflex,bladder perforation and postoperative bladder perforation repair in the observation group were lower than those in the control group(P<0.05).There were no significant differences in MAP and HR between two groups at T_(0)(P>0.05).At T_(1) and T_(2),MAP and HR in two groups were decreased,but the indexes in the observation group were higher than those in the control group(P<0.05).After anesthesia,stroke output and cardiac index decreased in both groups,but the indexes in the observation group were higher than those in the control group(P<0.05).Conclusion:The application of obturator nerve block guided by B-ultrasound in transurethral resection of bladder tumors can improve clinical indicators,reduce the occurrence of postoperative bladder perforation repair rate,have little impact on vital signs and stable hemodynamic level.

关 键 词：B超引导 闭孔神经阻滞 尿道膀胱肿瘤电切术 闭孔神经反射 

分 类 号：R737.14[医药卫生—肿瘤]