CAJ | 학술논문

目的：探讨膀胱肿瘤基底部注射灭菌注射用水预防闭孔神经反射的可行性。方法选择有可能发生闭孔神经反射的膀胱侧壁肿瘤病例76例，随机分为两组，均在腰麻下行经尿道膀胱肿瘤电切术（T U RB t ），实验组38例在膀胱肿瘤基底部注射灭菌注射用水直至肿瘤基底部隆起，适度充盈膀胱行TURBt ；对照组38例在适度充盈膀胱后直接行 TURBt。结果实验组38例患者有1例患者发生闭孔神经反射，为轻度反射，无膀胱穿孔、无周围组织损伤；对照组有8例患者发生闭孔神经反射，5例为轻度反射，2例为中度反射，1例为重度反射且致膀胱穿孔，术后随访至今实验组及对照组病例各有2例复发。其中对照组1例为原位复发，1例为异位复发，实验组2例均为异位复发。结论膀胱肿瘤基底部注射灭菌注射用水可有效预防闭孔神经反射的发生，减少并发症。
목적：탐토방광종류기저부주사멸균주사용수예방폐공신경반사적가행성。방법선택유가능발생폐공신경반사적방광측벽종류병례76례，수궤분위량조，균재요마하행경뇨도방광종류전절술（T U RB t ），실험조38례재방광종류기저부주사멸균주사용수직지종류기저부륭기，괄도충영방광행TURBt ；대조조38례재괄도충영방광후직접행 TURBt。결과실험조38례환자유1례환자발생폐공신경반사，위경도반사，무방광천공、무주위조직손상；대조조유8례환자발생폐공신경반사，5례위경도반사，2례위중도반사，1례위중도반사차치방광천공，술후수방지금실험조급대조조병례각유2례복발。기중대조조1례위원위복발，1례위이위복발，실험조2례균위이위복발。결론방광종류기저부주사멸균주사용수가유효예방폐공신경반사적발생，감소병발증。
Objective Discuss the feasibility of preventing obturator nerve reflex ,when inject sterilized water to the base of bladder tumor .Methods 76 bladder tumor cases were choosed ,which the obturator nerve may be stimulated ,then randomly divided into 2 groups .All these cases accepted the operation :transurethral resection of bladder tumor .The cases of experimental group were 38 ,we inject sterilized wa‐ter to the base of bladder tumor until the basilar part of bladder tumor was floated .When the bladder was filled with physiological saline ,we perform the operation :transurethral resection of bladder tumor .In the control group ,we fill the bladder with water and perform the surgery :transurethral resection of bladder tumor .Results Only one case had obturator nerve reflex in the experimental group ,It was a slightly reflex . There was no vesical perforation or surrounding tissue damage .However ,there were 8 in the control group .Slightly reflex were happened in 5 case ,moderately reflex were happened in 2 patient .Severely re‐flex was happened ,which induced vesical perforation in one case ,Now ,we find 2 recurrence patient both of experimental group and control group .One of the recurrence of control group in situ ,while another in a new place .But the recurrence of experimental group both in a new place .Conclusion Obturator nerve re‐flex can be prevent by inject sterilized water to the base of bladder tumor .