阴茎背根神经阻滞在男性儿童导尿困难中的应用探讨(附20例报告)

Application of Dorsal Penile Nerve Block for Urethral Catheterization in Male Pediatric Patients(Report of 20 Cases)

目的:探讨男性儿童在尿道外括约肌无法松弛而致导尿困难时应用阴茎背根神经阻滞(DPNB)的临床价值。方法:回顾性分析总结20例导尿困难的男性儿童应用1%利多卡因进行DPNB的经验。导尿过程中患儿的疼痛程度用Oucher量表评估。结果:20例患儿均为尿道外括约肌的无法松弛而致导尿管插入困难者,应用DPNB后,均导尿成功。背根神经阻滞后,患儿在导尿过程中较麻醉前疼痛减少(P<0.05)。平均操作时间8(6～12)min。导尿过程以及导尿后无并发症。结论:虽然DPNB并非男性儿童导尿时的常规操作,但尿道外括约肌紧张所致导尿困难时应用DPNB安全有效。

Objective：To evaluate the clinical effect of the use of dorsal penile nerve block（DPNB） for urethral catheterization in young boys who are unable to relax the external urethral sphincter during this procedure. Methods：We conducted DPNB on 20 boys. 1 % plain lidocaine was uesd as the local anesthetic. In all children,pain during catheterization was recorded and measured using the Oucher Pain Scale. Results：This application was successful in all 7 cases,on which previous attempts at bladder catheterization failed. After DPNB, patients had significantly lower pain （P〈0.05） during urethral catheterization than in initial attempts. The average operating time was 8 （6- 12） min. There were no complications observed during or after the procedure. ConClusions： Although DPNB is not commonly needed during urethral catheterization, this method described repeatedly permits successful urethral catheterization in young male patients who have difficulty in relaxing external urethral sphincter.