CAJ | 학술논문

目的：比较在腰硬联合麻醉（CSEA）或全身麻醉（GA）下TURBt手术治疗浅表性膀胱侧壁肿瘤的有效性和安全性。方法2012年1月至2014年6月，东莞市人民医院术前诊断为浅表性膀胱侧壁肿瘤患者60例，密闭信封法分为CSEA、GA两组。记录两组患者年龄、性别、ASA分级、病史和肿瘤大小、数目等临床资料，观察比较两组患者术中闭孔反射发生率、膀胱穿孔率、手术时间、出血量、住院费用，以及血压、心率、血氧饱和度变化情况。结果60例浅表性膀胱侧壁肿瘤患者纳入本研究， CSEA组和GA组分别30例，两组患者一般临床资料无统计学差异，术中两组患者生命体征均维持在正常范围内，CSEA组8例(26.7%)术中发生闭孔反射，其中1例出现膀胱穿孔，GA组无闭孔反射和膀胱穿孔病例，但GA组住院费用较CSEA组费用高（P<0.05）。结论 GA或CSEA均可用于TURBt治疗浅表性膀胱侧壁肿瘤，CSEA组患者住院费用低廉，但GA组患者术中安全性更好。
목적：비교재요경연합마취（CSEA）혹전신마취（GA）하TURBt수술치료천표성방광측벽종류적유효성화안전성。방법2012년1월지2014년6월，동완시인민의원술전진단위천표성방광측벽종류환자60례，밀폐신봉법분위CSEA、GA량조。기록량조환자년령、성별、ASA분급、병사화종류대소、수목등림상자료，관찰비교량조환자술중폐공반사발생솔、방광천공솔、수술시간、출혈량、주원비용，이급혈압、심솔、혈양포화도변화정황。결과60례천표성방광측벽종류환자납입본연구， CSEA조화GA조분별30례，량조환자일반림상자료무통계학차이，술중량조환자생명체정균유지재정상범위내，CSEA조8례(26.7%)술중발생폐공반사，기중1례출현방광천공，GA조무폐공반사화방광천공병례，단GA조주원비용교CSEA조비용고（P<0.05）。결론 GA혹CSEA균가용우TURBt치료천표성방광측벽종류，CSEA조환자주원비용저렴，단GA조환자술중안전성경호。
Objective To compare the efficacy and safety of combined spinal-epidural anesthesia (CSEA) and general anesthesia(GA) for transurethral resection of the bladder tumor. Methods Between January 2012 and June 2014, patients with superficial bladder tumor were randomly selected for CSEA or GA using envelopes and enrolled in this study. The clinical characteristics of Patients such as patients' blood pressure, heart rate, oxyhemoglobin saturation, operative time and side-effects in these two groups were evaluated. Results 60 cases were included in this study; 30 patients in CSEA group and 30 patients in GA group. No significant differences were found between the two groups in basic Characteristics. GA group experienced more stable hemodynamics than those in CSEA group. Obturator nerve reflex was observed in 8 (26.7%) patients in CSEA group, but none in GA group. However, the hospitalization expenses of GA group are signifcantly higher than CSEA group(P<0.05). Conclusion Both CSEA and EA are applicable to TURBt for superficial bladder tumor, but GA is more safety than CSEA for this procedure.