摘要
目的探讨骶尾神经阻滞下经会阴前列腺穿刺的可行性、安全性及与传统的经直肠穿刺的相对优势所在。方法选取本院2018年8月—2019年12月有前列腺穿刺活检指征患者64例,采用骶尾神经阻滞后行经会阴前列腺前列腺穿刺活检,采用VAS评分法探讨其效果。结果所有64例患者均完成骶尾神经阻滞,完成骶尾神经阻滞患者肛门括约肌均较阻滞前松弛,60例患者提睾肌反射及球海绵体反射较阻滞前减弱及完全消失,视觉模拟评分法(VAS)疼痛评估64例患者中0~1分者31例,2~3分者27例,4~6分3例,7分以上者3例,穿刺完成后64例患者中有3例出现发热,1例患者穿刺后出现尿道出血不止,其余患者均无需特殊使用抗生素等处理和无发热感染状况出现。结论骶尾神经阻滞下行经直肠超声引导下经会阴穿刺操作简单、方便及易行,安全及可行,尤其在基层医院,但仍存在诸多的可改进之处,后期研究中会针对性改良和深入研究探讨。
Objective To investigate the feasibility and safety of perineal prostatic puncture under sacrococcygeal nerve block and its comparative advantage over traditional transrectal puncture.Methods A total of 64 patients with prostate biopsy indications in our hospital from August 2018 to December 2019 were selected.After sacrococcygeal nerve block,perineal prostate biopsy was performed,and VAS score was used to investigate the effect.Results All 64 patients completed the sacral nerve block,complete tail sacral nerve block in patients with anal sphincter relaxation before than block,60 cases patients testosterone muscle reflex and sponge ball reflex decreased before a block or disappear completely,method of visual analogue scale(VAS)pain assessment 0 to 1 in 64 patients.In 31 cases,2 to 3 points in 27 cases,4 to 6 points in 3 cases,more than 7 points(3 cases),three of puncture after the completion of the 64 patients had fever,urethral bleeding after puncture,1 patients of them without the special use of antibiotics and other processing and no fever infection status.Conclusions Perineal puncture under the guidance of transrectal ultrasound under sacrococcygeal nerve block is simple,convenient,easy,safe and feasible,especially in primary hospitals,but there are still many improvements,which will be improved and discussed in the later study.
作者
瞿虎
钟文文
邱文锋
尧冰
王德娟
邱剑光
汪中扬
QYU Hu;ZHONG Wenwen;QIU Wenfeng;YAO Bing;WANG Dejuang;QIU Jianguang;WANG Zhongyang(Department of Urology,The Sixth Affiliated Hospital of Sun Yat-Sen University,Guangzhou Guangdong 510065,China)
出处
《中国继续医学教育》
2020年第8期106-108,共3页
China Continuing Medical Education
