闭孔神经阻滞在经尿道膀胱肿瘤电切术中的应用研究

目的：观察在经尿道膀胱肿瘤电切术中采用闭孔神经阻滞减少闭孔反射的情况及远期疗效。方法：选取2005年1月-2006年5月期间我科收治的60例确诊膀胱肿瘤患者,严格按照手术适应症随机分为两组：对照组30例单纯硬膜外麻下行经尿道肿瘤电切术,治疗组30例在硬膜外麻醉基础上进行闭孔神经阻滞,观察两组闭孔反射发生率并进行术后随访,观察肿瘤的复发情况。结果：对照组闭孔反射发生率明显高于治疗组（P〈0.05）,经过随访治疗组30例患者3例出现了膀胱肿瘤复发,复发率为10.0%,对照组复发率为13.3%（4/30）,两组复发率无明显差异（P〉0.05）。结论：在经尿道膀胱肿瘤电切术中采取闭孔神经阻滞能明显减少闭孔反射的发生,明显提高手术的效果,但是改善膀胱肿瘤近期和远期疗效还有待进一步探讨。

Clinical Application of Local Obturator Nerve Block Used in Transurethral Resection of Bladder Tumor

Objective： To observe the action of local obturator nerve block to prevent the occurrence of obturator nerve reflex during transurethral resection of bladder tumors and long-term efficacy. Methods： Sixty cases of bladder tumor were randomly divided into two groups from Jan. 2005 to May 2006. The patients were respectively given epidural anesthesia or epidural anesthesia adding obturator nerve block. Results： Adding obturator nerve block significantly reduced the rate of obturator nerve reflex （4/30 vs. 28/30, P〈0.05）. The recurrence rate had no significant difference between two groups after follow-up （3/30 vs. 4/30, P〉0. 05）. Conclusion： Application of local obturator nerve block can significantly reduce the rate of obturator nerve reflex in transurethral resection of bladder tumor, arid obviously improve operation＇s effect.