膀胱穿刺局部麻醉在预防膀胱侧壁肿瘤电切术中闭孔神经反射中的应用及其对膀胱功能恢复的影响  

Application of local anesthesia for bladder puncture in preventing obturator nerve reflex during transurethral resection of bladder lateral wall tumors and its impact on bladder function recovery

作　　者：王伟 侯慧洁 李安超 WANG Wei;HOU Huijie;LI Anchao(Department of Anesthesiology,General Hospital of Hebi Coal Industry(Group)Co.,Ltd.,Hebi 458000,China)

机构地区：[1]鹤壁煤业(集团)有限责任公司总医院麻醉科,河南鹤壁458000

出　　处：《肿瘤基础与临床》2024年第5期547-550,共4页journal of basic and clinical oncology

摘　　要：目的探究膀胱穿刺局部麻醉在预防膀胱侧壁肿瘤电切术中闭孔神经反射中的应用及其对膀胱功能恢复的影响。方法选取2021年12月至2023年12月在鹤壁煤业(集团)有限责任公司总医院行膀胱侧壁肿瘤电切术患者104例,随机数字表法均分为2组,每组52例,研究组52例采取硬膜外麻醉+膀胱穿刺局部麻醉,对照组52例采取硬膜外麻醉。比较2组手术情况、并发症、膀胱功能恢复情况。结果研究组导尿管留置时间、住院时间、中转开腹率、膀胱穿孔率、闭孔神经反射率均低于对照组(t=18.198,P<0.001;t=8.384,P<0.001;χ^(2)=5.253,P=0.022;χ^(2)=5.960,P=0.015;χ^(2)=22.061,P<0.001)。研究组拔管后即刻控尿率38.46%高于对照组17.31%(χ^(2)=5.786,P=0.016)。结论膀胱穿刺局部麻醉应用于膀胱侧壁肿瘤电切术中具有较好安全性,可降低闭孔神经反射率、中转开腹率与膀胱穿孔率,促进膀胱功能恢复。Objective To explore the application of local anesthesia for bladder puncture in preventing obturator nerve reflex during transurethral resection of bladder lateral wall tumors and its impact on bladder function recovery.Methods The 104 patients who underwent transurethral resection of bladder lateral wall tumors in our hospital from December 2021 to December 2023.The patients were divided into two groups,with 52 cases in each group.The study group(52 cases)received epidural anesthesia combined with bladder puncture local anesthesia,while the control group(52 cases)received epidural anesthesia alone.The surgical conditions,complications and bladder function recovery were compared between the two groups.Results The indwelling catheter time,hospitalization time,conversion rate to open surgery,bladder perforation rate and obturator nerve reflex rate in the study group were all lower than those in the control group(t=18.198,P<0.001;t=8.384,P<0.001;χ^(2)=5.253,P=0.022;χ^(2)=5.960,P=0.015;χ^(2)=22.061,P<0.001).The immediate continence rate after catheter removal in the study group(38.46%)was higher than that in the control group(17.31%)(χ^(2)=5.786,P=0.016).Conclusion The application of local anesthesia for bladder puncture in bladder sidewall tumor resection has good safety,which can reduce the obturator nerve reflectivity,conversion rate to open surgery and bladder perforation rate,promoting bladder function recovery.

关 键 词：膀胱侧壁肿瘤电切术 膀胱穿刺局部麻醉 闭孔神经反射 膀胱功能恢复 

分 类 号：R737.14[医药卫生—肿瘤]