摘要
目的:比较手术患者在使用表面麻醉、基础麻醉和两者联合用药后留置尿管对患者生理干扰程度、尿道粘膜损伤情况及插管是否顺利,探讨局部麻醉手术病人无痛导尿的可行性。方法:选择在局部麻醉下行胸腰椎骨折切开复位、减压固定的男性患者90例,将患者随机分为3组(每组30例),1组(表麻组),2组(强化组)和3组(表麻加强化组),各组用不同方法行留置尿管操作。结果:1组和2组在导尿前、中、后的心率、血压均升高明显(P<0.05),尿道损伤者较多,肉眼血尿或镜下血尿发生率也较高,患者疼痛明显。3组在导尿前、中、后的心率、血压均变化不明显,组内差异无统计学意义(P>0.05),尿道损伤几率较小。结论:单一的表麻或基础麻醉对男性患者都不能达到基本无痛状态下的导尿操作,只有将二者联合应用,才能实现导尿时无疼痛的感觉[1]。
Objective：The purpose of this paper is to compare the indwelling catheter effect of surface anesthesia,basic anesthesia and combination of both for patient physiological disturbance, urinary tract mucosal injury and intubation smoothness,and to investigate the feasibility of painless surgical catheterization with local anesthesia. The method we adopt is to choose a sample of 90 male patients of thoracolumbar fractures open reduction, decompression and fixation under local anesthesia,and randomly divide them into three groups （each with 30 patients）,group 1 （surface anesthesia group）,group2 （basic anesthesia group）and group 3 （combination of surface anesthesia and basic anesthesia）,each of which uses different methods of indwelling catheter line operation. Results show that in group 1 and group 2,before,during and after catheterization, the heart rate and blood pressure increased significantly （P〈0.05）,urethral injury was more likely,gross hematuria or microscopic hematuria incidence was higher,and patients were in significant pain. However,in group 3, before, during and after catheterization, the heart rate and blood pressure changes were not obvious, and the group difference was statically insignificant （P〉0.05）,urethral injury was less likely. So the conclusion is that simply by surface anesthesia or basic anesthesia on male patients,hardly can we achieve painless state catheterization operation. Only when combining the two, we could achieve catheterization without pain.
出处
《甘肃医药》
2014年第5期341-343,共3页
Gansu Medical Journal
关键词
地佐辛
局部麻醉
手术
无痛导尿
Dezocine
Cocai an esthesia
surgery
painless catheterization
