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目的总结耻骨后镇痛泵与硬膜外镇痛泵在防治TURP术后膀胱痉挛中的临床疗效,初步比较两种方法的效果与不足,从而为寻找一种更有效、安全、简便的术后镇痛方法提供参考。方法收集我院2006年6月～2009年5月TURP术后留置硬膜外镇痛泵病人208例,留置耻骨后镇痛泵病人56例,从术后抑制膀胱痉挛、减少再出血和再次手术率、置管的难易程度、安全性、并发症等方面比较两种方法的优缺点。结果硬膜外镇痛泵组平均置管时间(硬膜外麻醉置管时间加安置镇痛泵时间)为(45.56±8.72)分;术后出现明显膀胱痉挛80例,38例经上处理无效,29例出现再出血(27例与膀胱痉挛有关);术后出现各种镇痛泵并发症33例。耻骨后镇痛泵组平均置管时间(耻骨后穿刺置管加安置镇痛泵时间)为(12.65±4.35)分;术后出现膀胱痉挛仅9例。5例经处理后缓解,4例无效,3例出现再出血(2例与膀胱痉挛有关);术后出现各种镇痛泵并发症仅3例。结论耻骨后镇痛泵在防治TURP术后膀胱痉挛中比硬膜外镇痛泵更具疗效,能有效抑制膀胱痉挛、减少再出血并降低再次手术率,具有安置简便、安全可行、疗效确切、副作用和并发症少的优越性,值得推广应用。
Objective To summarize the clinical curative effect of post-pubopuensional analgesia pump and epidural analgesia pump in preventing and treating bladder spasm after TURP, and to compare the effects and deficiencies of the two methods in order to find a more effective, safe and simple postoperative Analgesic methods for reference. Methods Totally 208 patients with postoperative epidural analgesia pump after TURP in our hospital from June 2006 to May 2009 were enrolled in this study. Fifty-six patients with post-pubic analgesia pump were enrolled in this study. After operation, bladder spasm, reduced rebleeding and reoperation Rate, ease of catheterization, safety, complications, etc. compare the advantages and disadvantages of the two methods. Results The average catheterization time (epidural catheterization time and placement analgesia pump time) in the epidural analgesia pump group was (45.56 ± 8.72) minutes. There were 80 cases of obvious bladder spasm after operation and 38 cases were ineffective , 29 cases of rebleeding (27 cases associated with bladder spasm); postoperative complications of various analgesic pump in 33 cases. The mean catheterization time (the duration of retropubic catheterization and placement of analgesia pump) was (12.65 ± 4.35) minutes after operation in the retropubic analgesia group and only 9 cases of postoperative bladder spasm. 5 cases were treated and relieved, 4 cases were ineffective, and 3 cases showed rebleeding (2 cases were related to bladder spasm). There were only 3 cases of various analgesic pump complications after operation. Conclusion The retropubic analgesia pump is more effective than epidural analgesia pump in preventing bladder spasm after TURP. It can effectively inhibit bladder spasm, reduce rebleeding and reduce the rate of reoperation. It has the advantages of simple, safe and feasible curative effect, Advantages of less side effects and complications, it is worth promoting application.