PCEA和PCIA应用于下尿路术后膀胱痉挛的效果分析

Anagesia effects comparison of PCEA and PCIA on postoperative bladder spasm

目的:探讨实用、安全、有效的处理下尿路术后膀胱痉挛的方法。方法:选取我院2006～2008年收治的120例下尿路疾病手术患者,术后随机分成硬膜外自控镇痛术(PCEA)组及静脉自控镇痛术(PCIA)组,每组60例,分别采用PCEA、PCIA镇痛,均以2 mL/h匀速输入,平均置泵时间48h,术后观察50 h。结果:PCEA组术后膀胱痉挛发生率(10%)明显低于PCIA组(25%)(P<0.01);对术后镇痛总体满意度(90%)明显高于PCIA组(75%)(P<0.05),术后呼吸抑制、嗜睡发生率(1.6%)明显低于PCIA组(13%)(P<0.01)。结论:下尿路术后应用PCEA能明显减少膀胱痉挛的发生,不良反应较PCIA少,可大大提高术后患者的疗效及生活质量,且操作简单、方便、安全,值得临术进一步推广。

Objective：To explore a practical,safe and effective treatment for bladder spasm after lower urinary surgery.Methods：A total of 120 patients that underwent lower urinary tract surgery were randomly assigned to patient controlled epidural anagesia group（PCEA） and patient controlled intravenous anagesia group（PCIA） with 60 cases in each group.PCEA and PCIA at are 2mL/k were infused for the two groups for an average of 48 hours.Observation continued for 50 hours after surgery.Results：Incidence of bladder spasm of the PCEA group was 10%,significant lower than the 25% in PCIA group（P0.01）;Overall satisfaction about the postoperative analgesia effects and incidence of respiratory depression or drowsiness of PCEA and PCIA group was 90% vs 75%,and 1.6% vs 13%（P both 0.05）.Conclusion：PCEA can significantly decrease the incidence of bladder spasm for patients that undergo lower urinary tract surgery with less side effects comparing with PCIA,thus it can improve patients life quality.As a simple,safe and convenient treatment,it worth application in large scale.