摘要
目的观察B超引导下闭孔神经阻滞预防老年患者经尿道膀胱肿瘤电切术(TURBt)中闭孔神经反射的疗效。方法选取2019年6月—2019年9月在复旦大学附属华东医院择期行TURBt术的老年患者74例,使用随机数字表法分为观察组(n=37)和对照组(n=37)。观察组在单次蛛网膜下腔麻醉后行B超引导下闭孔神经阻滞,对照组仅行单次蛛网膜下腔麻醉。观察2组术中闭孔神经反射的发生率、反射强度、手术时间及膀胱穿孔出血等并发症。术后观察2组下肢感觉恢复时间、运动恢复时间、下床活动时间及患者满意度VAS评分。结果观察组闭孔神经反射发生率少于对照组(5.40%vs16.21%,P<0.01);2组手术时间差异无统计学意义(35.5±12.2)min(38.6±15.1)min,P>0.05;术后2组下肢感觉恢复时间,运动恢复时间、下床活动时间及患者满意度VAS评分之间差异无统计学意义。结论B超引导下闭孔神经阻滞可有效降低老年患者经尿道膀胱肿瘤电切术中闭孔神经反射的发生率,提高手术安全性。
Objective To observe the effect of obturator nerve blocking guided by B-ultrasound in preventing obturator nerve reflex in transurethral resection of bladder tumor(TURB)in the elderly.Methods 74 elderly cases undergoing TURB during the period from June,2019 to September,2019 were randomly divided into 2 groups:observation group and control group,37 in each;single subarachnoid anesthesia with obturator nerve blocking guided by B-ultrasound was given to the elderly in observation group while single subarachnoid anesthesia to the elderly in control group;in operation,the incidence of obturator nerve reflex,reflex intensity,operation time length and bladder perforation bleeding were observed and after operation,the sensory recovery time,motor recovery time,off-bed activity time and VAS score of patient satisfaction were observed.Results The incidence of obturator nerve reflex was less in observation group than that in control group(5.40%.16.21%,P<0.01);there was no statistical difference between the 2 groups in operation time length[(35.5±12.2)min.(38.6±15.1)min],sensory recovery time,motor recovery time,out of bed activity time and VAS scores of patient satisfaction(P>0.05).Conclusion Obturator nerve blocking guided by B-ultrasound can effectively reduce the incidence of obturator nerve reflex and greatly improve the safety of the elderly during TURB.
作者
沈云
张豪杰
许迎华
Shen Yun;Zhang Haojie;Xu Yinghua(Department of Anesthesiology,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Department of Urology,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)
出处
《老年医学与保健》
CAS
2020年第1期101-102,121,共3页
Geriatrics & Health Care
基金
上海市卫生计生系统重要薄弱学科—老年医学(2015ZB0501)
关键词
老年
超声引导
闭孔神经阻滞
闭孔神经反射
elderly
ultrasound guidance
obturator nerve block
obturator reflex
