CAJ | 학술논문

目的：观察硬膜外自控镇痛泵（PCEA）防治前列腺术后膀胱痉挛的失败原因，探讨补救措施。方法总结10年来PCEA防治前列腺术后膀胱痉挛的临床资料，分析PCEA防治前列腺术后膀胱痉挛的失败原因。结果本组11例，2例自控泵电源不足，3例硬膜外导管滑脱，1例导管阻塞，1例接头漏液，3例麻药配方剂量不足，1例硬膜外腔粘连。以上问题出现分别予以更换电池、静脉自控泵镇痛、更换三通管接头和应用盐酸屈他维林以补救。11例均达到防治膀胱痉挛的满意效果，未出现严重血尿和术后切口感染等严重并发症。结论 PCEA防治前列腺术后膀胱痉挛效果肯定，一旦发现术后镇痛效果不佳，及时分析原因，并予以纠正或采取其他方法防止膀胱痉挛，以免引起出血、感染等严重并发症。
목적：관찰경막외자공진통빙（PCEA）방치전렬선술후방광경련적실패원인，탐토보구조시。방법총결10년래PCEA방치전렬선술후방광경련적림상자료，분석PCEA방치전렬선술후방광경련적실패원인。결과본조11례，2례자공빙전원불족，3례경막외도관활탈，1례도관조새，1례접두루액，3례마약배방제량불족，1례경막외강점련。이상문제출현분별여이경환전지、정맥자공빙진통、경환삼통관접두화응용염산굴타유림이보구。11례균체도방치방광경련적만의효과，미출현엄중혈뇨화술후절구감염등엄중병발증。결론 PCEA방치전렬선술후방광경련효과긍정，일단발현술후진통효과불가，급시분석원인，병여이규정혹채취기타방법방지방광경련，이면인기출혈、감염등엄중병발증。
Objective To investigate the failure causes and remedial measures of bladder spasm of patient-controlled epidural analgesia pump treatment after prostatectomy. Methods Clinical data of patient who received controlled epidural analgesia pump treatment of bladder spasm after prostatectomy in last ten years were summarized and reviewed retrospectively, andthe failure causes for bladder spasm of patient-controlled epidural analgesia pump treatment after prostatectomy were analzed. Results The group of 11 cases, 2 cases of controlled pump power supply, 3 cases of epidural catheter slippage, catheter obstruction in 1 cases, 1 cases of joint leakage, 3 cases of deficiency of anesthetic dose formula, 1 cases of epidural adhesion. All of the above problems are to replace the battery, patient-controlled intravenous analgesia, joint replacement and application of three pipe Drotaverine to remedy. All 11 cases achieved satisfactory effect in the prevention of bladder spasm, no severe hematuria and serious complication after incision infection. Conclusion Sure of bladder spasm after prostatectomy PCEA prevention effect, once found the postoperative analgesia effect is poor, timely analysis of the causes, and corrected or adopt other methods to prevent bladder spasm, so as not to cause serious complications of bleeding, infection and so on.