超声引导下近端肌筋膜闭孔神经阻滞在经尿道膀胱肿瘤电切术中的应用

Application of ultrasound-guided proximal myofascial obturator nerve block in transurethral resection of bladder tumor

目的:观察超声引导下近端肌筋膜闭孔神经阻滞在经尿道膀胱肿瘤电切术中效果。方法:选择2017年3月~2019年8月择期行经尿道膀胱肿瘤电切术的患者120例,随机分成观察组和对照组每组60例。观察组采用超声引导下近端肌筋膜闭孔神经阻滞,而对照组采用超声引导下远端肌筋膜闭孔神经阻滞。观察两组神经阻滞操作时间、阻滞成功率、手术时间、膀胱穿孔、出血、肠道受损等并发症以及用药剂量。结果:观察组较对照组神经阻滞操作时间、手术时间短,阻滞成功率、大腿内收肌收缩肌力下降率高,差异有统计学意义(P<0.05)、膀胱穿孔、出血、肠道受损发生率显著降低,差异有统计学意义(P<0.05)。结论:超声引导下近端肌筋膜闭孔神经总支阻滞可以显著降低经尿道膀胱肿瘤电切术中并发症发生率,较闭孔神经分支阻滞组有更高的有效率、安全性高,值得临床推广。

Objective To observate the effection of ultrasound-guided proximal myofascial obturator nerve block in transurethral resection of bladder tumor.Method 120 patients who underwent transurethral resection of bladder tumor in our hospital from March 2017 to August 2019 were randomly divided into observation group(n=60)and control group(n=60).Observation group was treated with ultrasound-guided proximal myofascial obturator nerve block,while control group was treated with distal myofascial obturator nerve block guided by ultrasound.The nerve block operation time,block success rate,operation time,bladder perforation,bleeding,intestinal injury and other complications and drug dosage were recorded in the two groups.Results The operation time and operation time of nerve block in observation group were shorter than those in control group(P<0.05).The success rate of block,the decrease rate of contractile muscle strength of adductor muscle of thigh,bladder perforation,bleeding and intestinal injury in observation group were significantly lower than those in control group(P<0.05).Conclusion Conclusion Ultrasound-guided proximal myofascial obturator nerve branch block can significantly reduce the incidence of complications in transurethral resection of bladder tumor,which is more effective and safe than that in obturator nerve branch block group.