CAJ | 학술논문

目的通过比较超声联合神经刺激仪引导及单纯神经刺激仪引导下闭孔神经阻滞(ONB),探讨超声联合神经刺激仪引导 ONB 的可行性及先进性。方法需行 ONB 的经尿道膀胱肿瘤电切术(TURBT)患者60例,男女不限,年龄39~77岁,BMI 19~30 kg/m2,随机均分为神经刺激仪组(S 组)和超声联合神经刺激仪组(US 组),S 组患者在神经刺激仪引导下经典入路行 ONB；US组患者在超声联合神经刺激仪引导下行 ONB。神经阻滞过程中记录两组患者穿刺中最高 VAS 评分、穿刺一针成功率、穿刺内收肌收缩时间间隔、穿刺次数、穿刺深度、阻滞后大腿内收肌力、成功率及并发症等指标。结果两组患者 ONB 成功率、阻滞后大腿内收肌力、并发症发生率差异无统计学意义；一针成功率 US 组明显高于 S 组(P <0.01)；US 组最高 VAS 评分明显低于,穿刺内收肌收缩时间间隔明显短于,诱发收缩穿刺次数明显少于,穿刺深度明显浅于 S 组(P <0.05)。结论与经典入路神经刺激仪引导下 ONB 比较,超声联合神经刺激仪引导下 ONB 定位更准,操作更快,患者痛苦更小。
목적통과비교초성연합신경자격의인도급단순신경자격의인도하폐공신경조체(ONB),탐토초성연합신경자격의인도 ONB 적가행성급선진성。방법수행 ONB 적경뇨도방광종류전절술(TURBT)환자60례,남녀불한,년령39~77세,BMI 19~30 kg/m2,수궤균분위신경자격의조(S 조)화초성연합신경자격의조(US 조),S 조환자재신경자격의인도하경전입로행 ONB；US조환자재초성연합신경자격의인도하행 ONB。신경조체과정중기록량조환자천자중최고 VAS 평분、천자일침성공솔、천자내수기수축시간간격、천자차수、천자심도、조체후대퇴내수기력、성공솔급병발증등지표。결과량조환자 ONB 성공솔、조체후대퇴내수기력、병발증발생솔차이무통계학의의；일침성공솔 US 조명현고우 S 조(P <0.01)；US 조최고 VAS 평분명현저우,천자내수기수축시간간격명현단우,유발수축천자차수명현소우,천자심도명현천우 S 조(P <0.05)。결론여경전입로신경자격의인도하 ONB 비교,초성연합신경자격의인도하 ONB 정위경준,조작경쾌,환자통고경소。
Objective Comparing the effects of ultrasound with nerve stimulation guided obtu-rator nerve block(ONB)with simple nerve stimulation guided ONB for transurethral resection of blad-der tumor(TURBT),so as to realize the validity and advantages of ultrasound with nerve stimulation guided ONB.Methods Sixty ASA Ⅰ or Ⅱ,male or female,age 39-77 years old,BMI 1 9-30 kg/m2 patients undergoing elective TURBT were randomly divided into two groups,nerve stimulation group (group S)and ultrasound and nerve stimulation group (group US).Success rate of the first puncture, visual analog scale (VAS)pain score,insertion-adductor contraction interval (ICI),puncture times corresponding to ICI,adductor strength,incidence of complications and validity were observed during and after ONB.Results There was no significant difference of the general validity,adductor strength and complication incidence between the two groups.The success rate of the first puncture was signifi-cantly higher in group US than that in group S (P < 0.01).VAS pain score,ICI and puncture times were significantly lower in group US than those in group S (P < 0.05).Conclusion Compared with simple nerve stimulation guided ONB,ultrasound with nerve stimulation guidance showed less punc-ture time,more accurate positioning and more comfort.