[1]姚鑫泉,陈红其,孟凡喜,等.膀胱肿瘤基底部不同层面阻滞麻醉预防闭孔神经反射的比较[J].中华腔镜泌尿外科杂志(电子版),2010,(04):270-272.
 YAO Xin-quan,CHEN Hong-qi,MENG Fan-xi,et al.Different histologic layer anasthesia in preventing obturator nerve reflex during transurethral resection of bladder tumors: a comparative study[J].,2010,(04):270-272.
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膀胱肿瘤基底部不同层面阻滞麻醉预防闭孔神经反射的比较()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2010年04期
页码:
270-272
栏目:
出版日期:
1900-01-01

文章信息/Info

Title:
Different histologic layer anasthesia in preventing obturator nerve reflex during transurethral resection of bladder tumors: a comparative study
作者:
姚鑫泉陈红其孟凡喜沈宇刘奎杨正皓李强
江苏盛泽医院,江苏省人民医院盛泽分院,泌尿外科,苏州,215000
Author(s):
YAO Xin-quanCHEN Hong-qiMENG Fan-xiSHEN YuLIU KuiYANG Zheng-haoLI Qiang
关键词:
膀胱肿瘤经尿道电切术闭孔神经神经阻滞
摘要:
目的 探讨膀胱肿瘤基底部黏膜下阻滞与肌层及黏膜下同时阻滞预防电切术中闭孔神经反射的效果差异.方法 2000年1月至2009年5月对收治的膀胱侧壁肿瘤患者,在电切术前用滚珠状电极电灼刺激肿瘤基底部进行测试,证实存在闭孔神经反射的76例被随机分为A、B两组,用2%利多卡因行肿瘤基底部浸润注射,其中A组38例行肿瘤基底部黏膜下注射,B组38例则行肌层及黏膜下同时注射.结果 A组有28.95%(11例)患者在电切时发生不同程度的闭孔神经反射,B组发生轻微反射5.26%(2例),差异有统计学意义.对仍出现闭孔神经反射的13例,用电切环切除瘤体,而肿瘤基底部及其周围组织改用滚珠状或汽化电极进行汽化,防止了膀胱穿孔的发生.结论 术前应用滚珠状电极电灼刺激肿瘤基底部,不仅能帮助识别是否存在闭孔神经反射,而且操作直观安全;用利多卡因浸润注射肿瘤基底部肌层及黏膜下,能有效降低闭孔神经反射发生率,肌层和黏膜下同时注射效果明显优于单纯黏膜下注射.

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备注/Memo

备注/Memo:
苏州市科技计划项目(WS200812)
更新日期/Last Update: 1900-01-01