CSEA与CEA在经尿道前列腺电切术中的应用比较

Application comparison of CSEA and CEA on transurethral prostatic resection

目的:探讨腰硬联合麻醉(CSEA)与硬膜外麻醉(CEA)在经尿道前列腺电切术(TURP)中的应用效果。方法:按麻醉方法不同将130例ASAⅠ～Ⅱ级择期行TURP的良性前列腺增生(BPH)患者分为CSEA组(76例)和CEA组(54例)。观察两组患者的麻醉效果及不良反应。结果:CSEA组感觉阻滞起效时间和运动阻滞起效时间明显早于CEA组(均P<0.05),感觉阻滞持续时间和运动阻滞持续时间明显长于CEA组(均P<0.05),Bromage3级率明显高于CEA组(P<0.05),而最高感觉阻滞平面与CEA组差异无统计学意义(P>0.05);CEA组麻醉优秀率明显低于CSEA组(P<0.05);CSEA组并发症发生率(13.2%)明显低于CEA组(20.4%)(P<0.05)。结论:CSEA简便,起效快,麻醉完善,平面易控,并发症少,相比CEA,更适宜应用于TURP。

Objective：To investigate the application effects of combined spinal epidural anesthesia（CSEA） and epidural anesthesia（CEA） on transurethral prostatic resection.Methods：According to anesthesia methods,130 cases of ASAⅠ~Ⅱ grade scheduled for TURP for BPH patients were divided into the CSEA group（76 cases） and the CEA groups（54 cases）.Anesthetic effects and adverse reactions were observed.Results：The onset time of sensory block and motor block in CSEA group were earlier than that in the CEA group（P0.05）,duration of sensory block and motor block were significantly longer than that in the CEA group（all P0.05）,Bromage3 level was significantly higher than that in the CEA group（P0.05）,the highest sensory block plane was no significantly different between groups（P0.05）;anesthesia excellent rate of CEA group was significantly lower than that in the CSEA group（P0.05）;the complication rate of CSEA group（13.2%） was significantly lower than that in the CEA group（20.4%）（P0.05）.Conclusion：CSEA is simple,faster onset time,the plane is easy to control,with fewer complications,compared with CEA,it is more suitable to apply in TURP.