CAJ | 학술논문

目的：经尿道前列腺电切术（TURP）患者术后应用两种镇痛方式，观察镇痛及缓解膀胱痉挛的效果以及患者舒适度的差异，总结护理经验。方法 TURP(Transurethral resection of the prostate)术后患者，术后分别行硬膜外自控镇痛(PCEA patient-control ed epidural analgesia )和静脉自控镇痛（PCIA patient-control ed intravenous analgesia）.随机分为两组，E组：0.2%罗哌卡因+0.5ug/ml舒芬太尼+阿扎司琼20mg，总量100ml，行PCEA。V组：喷他佐辛150mg+0.5ug/ml舒芬太尼+阿扎司琼20mg，总量100ml，行PCIA.。记录疼痛视觉模拟评分（visual analogue scale,VAS）、以及膀胱痉挛人数、膀胱持续冲洗时间、恶心呕吐等不良事件。结果两组患者年龄、体重、ASA分级、手术时间差异无统计学意义( P＞0.05)。两组比较，镇痛开始后4,8,16,20,24,48hVAS 评分无明显不同(P＞0.05)，但膀胱痉挛人数和冲洗时间有明显差异(P＜0.05)，恶心呕吐项亦有所不同(P＜0.05)。结论通过护理观察知，术后镇痛在缓解膀胱痉挛有明显效果，使病人更舒适，且并发症少。
목적：경뇨도전렬선전절술（TURP）환자술후응용량충진통방식，관찰진통급완해방광경련적효과이급환자서괄도적차이，총결호리경험。방법 TURP(Transurethral resection of the prostate)술후환자，술후분별행경막외자공진통(PCEA patient-control ed epidural analgesia )화정맥자공진통（PCIA patient-control ed intravenous analgesia）.수궤분위량조，E조：0.2%라고잡인+0.5ug/ml서분태니+아찰사경20mg，총량100ml，행PCEA。V조：분타좌신150mg+0.5ug/ml서분태니+아찰사경20mg，총량100ml，행PCIA.。기록동통시각모의평분（visual analogue scale,VAS）、이급방광경련인수、방광지속충세시간、악심구토등불량사건。결과량조환자년령、체중、ASA분급、수술시간차이무통계학의의( P＞0.05)。량조비교，진통개시후4,8,16,20,24,48hVAS 평분무명현불동(P＞0.05)，단방광경련인수화충세시간유명현차이(P＜0.05)，악심구토항역유소불동(P＜0.05)。결론통과호리관찰지，술후진통재완해방광경련유명현효과，사병인경서괄，차병발증소。
Objective: two kinds of methods of analgesia in transurethral resection of prostate (TURP) patients, comfort difference observed analgesia and al eviate the effects of bladder spasm and patients, to sum up the nursing experience. Methods: TURP (Transurethral resection of the prostate) patients after surgery, respectively, patient-control ed epidural analgesia (PCEA patient-control ed epidural analgesia) and patient-control ed intravenous analgesia (PCIA patient-control ed intravenous analgesia) were divided into two groups, group E: 0.2%+0.5ug/ml ropivacaine with sufentanil + Azasetron 20mg, total 100ml, PCEA. Group V: pentazocine 150mg+0.5ug/ml sufentanil + Azasetron 20mg, total 100ml, PCIA. Record the pain visual analog scale (visual analogue scale, VAS), as wel as the number of bladder spasm, bladder flushing time. nausea and vomiting and other adverse events. Results: there was no significant difference in two groups of patients age, weight, ASA classification, operation time difference (P > 0.05). The comparison between the two groups, analgesic started after the 4,8,16,20,24,48hVAS had no significant difference (P > 0.05), but there are obvious differences in the number of bladder spasm and washing time (P < 0.05), nausea and vomiting item is different (P < 0.05). Conclusion: appropriate care, the effect of patient control ed epidural analgesia is good, can effectively reduce the bladder spasm, shorten washing time, fewer complications .