中西医结合治疗前列腺摘除术后膀胱痉挛

Combination of Chinese Medicine and Western Medicine in Treating Bladder Spasm Following Prostatectomy

目的 :观察芬太尼硬膜外注射结合中医治疗对耻骨上经膀胱前列腺摘除术后膀胱痉挛的疗效。方法 :6 0例病人随机分为治疗组和联合治疗组。治疗组应用芬太尼硬膜外注射 (10 μg/h) ,联合治疗组应用芬太尼硬膜外镇痛结合中医三阴交穴位注射黄体酮及口服解痉汤治疗。结果 :膀胱痉挛发生率 :2 4h内治疗组为 4 0 % (12 / 30 ) ,联合治疗组为 16 .6 7% (5 / 30 ) ,两者比较有显著差异 ,P <0 .0 5。 2 4～ 4 8h治疗组为 30 % (9/ 30 ) ,联合治疗组为 3.3% (1/ 30 ) ,两组比较有显著差异 ,P <0 .0 5。膀胱痉挛缓解率 :治疗组为 2 5 % (3/ 12 ) ;联合治疗组为 80 % (4/ 5 ) ,两组比较有显著差异 ,P <0 .0 5。结论 :硬膜外镇痛结合中医穴位注射及中药口服治疗可明显降低前列腺摘除术后膀胱痉挛的发生率 。

Objective: to observe the effect of Chinese medicine and epidural injection of Fentany in treating bladder spasm after prostatectomy. Methods: 60 patients were divided into 2 groups with ”treatment group” and ”combined treatment group” in randomly. Epidural injection of Fentany(10μg/h), injection of progesterone at sanyinjiao and jiejingtang oral administration were used in ”combined treatment group” when epidural injection of Fentany was used in ”treatment group”.Results: In 24 hours after operation ,bladder spasm was occurred in 40% (12/30)patients in treatment group, 16.67%(5/30)in combined treatment group( P <0.05). In 24～48 hours after operation, bladder spasm was occurred in 30%(9/30)in treatment group and 3.3%(1/30)in combined treatment group( P < 0.05 ). The release rate of bladder spasm was 25%(3/12)in treatment group and 80%(4/5)in combined treatment group( P < 0.05 ). Conclusion: Combined Epidural injection of Fentany, injection of progesterone at sanyinjiao with jiejingtang oral administration can decrease the occurrence of bladder spasm and increase its release rate obviously.