三种麻醉方法在商环包皮环切中的效果比较

Comparison of the effects of three anesthesia methods in Shang ring circumcision

目的探讨三种麻醉方法在商环包皮环切中的效果。方法选取2018年2月至2019年8月郑州大学第一附属医院男科和兰考县中医院男科门诊收治的1138例包皮过长或包茎患者,采用随机数字表法分为三组,阴茎阻滞麻醉组329例、包皮静脉麻醉组342例、包皮表面麻醉组467例。阴茎阻滞麻醉组采用阴茎阻滞麻醉法,包皮静脉麻醉组采用包皮静脉麻醉法,包皮表面麻醉组采用包皮表面麻醉法。对三种麻醉方法的麻醉用时、麻醉时疼痛评分、术中疼痛评分、术后24 h疼痛评分、术后48 h疼痛评分、手术时间、愈合时间、并发症进行比较。结果包皮表面麻醉组和包皮静脉麻醉组的手术时间、麻醉中、术中及术后24、48 h疼痛评分、愈合时间、并发症明显优于阴茎阻滞麻醉组,差异有统计学意义(P<0.05)。其中包皮表面麻醉组在麻醉时疼痛、手术时间方面优于包皮静脉麻醉组(P<0.05)。包皮静脉麻醉组的麻醉用时短于其余两组,差异有统计学意义(P<0.05),包皮表面麻醉组的麻醉用时长于其余两组,差异有统计学意义(P<0.05)。结论包皮表面麻醉法在商环包皮环切手术中麻醉效果可靠,操作简单方便,副作用较少,愈合时间快,适合临床广泛推广。

Objective To investigate the effects of three anesthesia methods in Shang ring circumcision.Methods From February 2018 to August 2019,1138 patients with redundant prepuce or phimosis admitted to the Outpatient Clinics of the Department of Andrology in the First Affiliated Hospital of Zhengzhou University and Lankao Hospital of Traditional Chinese Medicine were divided into three groups by using the random number table method,with 329 cases in the penile block anesthesia group,342 cases in the prepuce intravenous anesthesia group,and 467 cases in the prepuce surface anesthesia group.The study methods of each of the three groups were respectively penile block anesthesia(penile block anesthesia group),prepuce intravenous anesthesia(prepuce intravenous anesthesia group),and prepuce surface anesthesia(prepuce surface anesthesia group).The anesthesia duration,pain score during anesthesia,intraoperative pain score,postoperative pain score at 24 h,postoperative pain score at 48 h,operating duration,healing time,and complications were compared among the three anesthesia methods.Results The operating duration,pain score during anesthesia,intraoperative pain score and postoperative pain score at 24 h and 48 h,healing time,and complications of the prepuce surface anesthesia group and the prepuce intravenous anesthesia group were significantly better than those of the penile block anesthesia group,with statistically significant differences(P<0.05).Compared with the prepuce intravenous anesthesia group,the prepuce surface anesthesia group was more advantageous in terms of pain during anesthesia,and operating duration(P<0.05).The anesthesia duration in the prepuce intravenous anesthesia group was shorter than that in the remaining two groups,with statistically significant difference(P<0.05).Meanwhile,the anesthesia duration in the prepuce surface anesthesia group was longer than that in the remaining two groups,with statistically significant difference(P<0.05).Conclusion The anesthesia effect of prepuce surface anesthesia method in Shang ring circumcision is reliable,simple and convenient to operate,with few side effects and short healing time,which is suitable for wide promotion in clinic.