摘要
目的通过麻醉诱导前给予药物治疗和／或心理干预的方法，评估不同方法预防全身麻醉术后男性患者尿管相关膀胱刺激症（CRBD）的临床效果。方法选择全身麻醉下行上腹部择期手术的男性患者80例，采用随机数字表法分为四组：对照组（c组）、复方利多卡因乳膏组（L组）、心理干预组（B组）、复方利多卡因乳膏联合心理干预组（LB组），每组20例。评估各组患者气管导管拔除后CRBD的发生情况，记录芬太尼用量及需额外应用氟比洛芬酯缓解CRBD疼痛不适的病例数。结果LB组术后无CRBD发生率[90％（18／20）]高于c、L、B组[分别为15％（3／20）、60％（12／20）、50％（10／20）]，差异有统计学意义（P〈0．05）；LB组轻度CRBD发生率[10％（2/20）]低于C、L、B组[分别为45％（9／20）、35％（7／20）、40％（8／20）]，差异有统计学意义（P〈0．05）。四组患者芬太尼用量比较差异无统计学意义（P〉0．05）。C组患者气管导管拔除后发生中、重度CRBD，需要应用氟比洛芬酯率显著高于L、B、LB组[40％（8／20）比5％（1／20）、10％（2／20）、0]，差异有统计学意义（P〈0．05）。结论单纯采用利多卡因乳膏或心理干预方法，可以有效降低气管导管拔除后男性患者CRBD的发生率。而采用利多卡因乳膏联合心理干预的方法基本上可以避免CRBD的发生，值得在临床工作中推广和应用。
Objective To explore the effect of compound lidocaine cream and/or psychotherapy in preventing the catheter-related bladder discomfort （CRBD） of male patients with operation under general anesthesia. Methods Eighty male patients undergoing selective upper abdomen operation were selected, and the patients were divided into 4 groups by random digits table method with 20 cases each： eontrol group （C group）, compound lidocaine cream group （L group）, psychotherapy group （B group） and eompound lidocaine cream combined with psychotherapy group （LB group）. The incidence of CRBD after extubation, dosage of fentanyl and the number of patients who need flurbiprofcn axetil to relief the pain of CRBD were compared among the 4 groups. Results The incidence of no CRBD after operation in LB group was significantly higher than that in C, L and B group： 90% （18/20） vs. 15% （3/20）, 60% （12/20） and 50% （10/20）, and there were statistical differences （P 〈 0.05）. The incidence of mild CRBD in LB group was signifieandy lower than that in C, L and B group： 10% （2/20） vs. 45% （9/20）, 35% （7/20） and 40% （8/20）, and there were statistieal differences （P 〈 0.05）. There were no statistical differenees in dosage of fentanyl among the 4 groups （P 〉 0.05）. The rate of patients who need flurbiprofen axetil to relief the pain of CRBD in C group was significantly higher than that in L, B and LB group： 40% （8/20） vs. 5% （1/20）, 10% （2/20） and O, and there were statistical differences （P 〈 0.05）. Conclusions Both the means of compound lidocaine cream and psychotherapy can reduce the incidence of CRBD. However, the method of compound lidocaine eream combined with psychotherapy is able to basically avoid the occurrence of CRBD, and it is worth spreading in clinic.
出处
《中国医师进修杂志》
2016年第4期296-299,共4页
Chinese Journal of Postgraduates of Medicine
