经尿道电切膀胱中闭孔神经反射的防治

The prevention of obturator nerve reflex for transurethral resection of bladder tumor

目的:预防和治疗在经尿道电切膀胱肿瘤时闭孔神经发生的反射性内收肌痉挛。方法:经尿道电切膀胱肿瘤病人32例,随机分为三组,I组19例,采用连续硬膜外麻醉,辅以闭孔神经阻滞,II组8例,采用腰-硬联合阻滞,辅以闭孔神经阻滞,III组5例,采用腰-硬联合麻醉,不加闭孔神经阻滞。结果:与III组比较,I组、II组的闭孔神经反射发生率明显降低(P<0.01),I组和II组之间闭孔神经反射发生率无明显差异(P>0.05)。结论:椎管内麻醉辅以闭孔神经阻滞能较好的预防闭孔神经反射的发生,避免膀胱穿孔等并发症。

Objective To prevent the occurrence of obturator nerve reflex result in severe muscle spasm during transurethral resection of bladder tumors. Method 32 cases were randomly divided into three groups .The patients were respectively used epidural anesthesia adding obturator nerve block or spinal anesthesia adding obturator nerve block. Results The former two groups significantly reduced the rate of obturator nerve reflex （P〈0.01）. Conclusion The former two groups can obtain a better way to prevent both the occurrence of obturator nerve reflex and the complication rate of bladder puncture.