CAJ | 학술논문

目的：观察不同浓度和剂量布比卡因对蛛网膜下腔阻滞患者术后尿潴留的影响。方法下腹部或下肢手术患者120例，随机分为4组，分别采用0.250％（Ⅰ组），0.375％（Ⅱ组），0.500％（Ⅲ组）等比重布比卡因3 ml 于 L2-3间隙行蛛网膜下腔阻滞，并于硬膜外向头侧置管3 cm。对照组（C 组）采用0.5％罗哌卡因单纯硬膜外麻醉。观察患者麻醉效果、生命体征变化，记录处理过程，手术24 h 后随访患者排尿功能的改变以及是否留置尿管。结果与Ⅰ组比较，Ⅱ组和Ⅲ组患者单次蛛网膜下腔阻滞效果更优（P ﹤0.05），Ⅱ组和Ⅲ组差异无统计学意义 P ﹥0.05）；术后尿管留置率：Ⅰ组、Ⅱ组、C 组三组比较差异无统计学意义（P ﹥0.05），且均低于Ⅲ组（P ﹤0.05）。结论0.375％布比卡因3 ml 用于蛛网膜下腔阻滞能较快达到手术麻醉要求，且有较低尿潴留的发生率。
목적：관찰불동농도화제량포비잡인대주망막하강조체환자술후뇨저류적영향。방법하복부혹하지수술환자120례，수궤분위4조，분별채용0.250％（Ⅰ조），0.375％（Ⅱ조），0.500％（Ⅲ조）등비중포비잡인3 ml 우 L2-3간극행주망막하강조체，병우경막외향두측치관3 cm。대조조（C 조）채용0.5％라고잡인단순경막외마취。관찰환자마취효과、생명체정변화，기록처리과정，수술24 h 후수방환자배뇨공능적개변이급시부류치뇨관。결과여Ⅰ조비교，Ⅱ조화Ⅲ조환자단차주망막하강조체효과경우（P ﹤0.05），Ⅱ조화Ⅲ조차이무통계학의의 P ﹥0.05）；술후뇨관류치솔：Ⅰ조、Ⅱ조、C 조삼조비교차이무통계학의의（P ﹥0.05），차균저우Ⅲ조（P ﹤0.05）。결론0.375％포비잡인3 ml 용우주망막하강조체능교쾌체도수술마취요구，차유교저뇨저류적발생솔。
Objective To investigate the effects of different concentration and dose of bupiva-caine on postoperative urinary retention in the patients undergoing subarachnoid anesthesia. Methods A total of 120 patients undergoing lower limp or hypogastrium surgery were randomly assigned to four groups (n = 30 in each). To induce a subarachnoid anesthesia,3 ml of isobaric bupivacaine was injected in group Ⅰ,Ⅱ,and Ⅲ(0. 250% ,0. 375% ,and 0. 500% ,respectively)via an intervertebral puncture between L2 and L3. All the patients received cephalic insertion of 3 cm of the epidural catheter. The con-trol group(group C)received epidural anesthesia with 0. 5% ropivacaine only. Anesthetic effect,vital signs,and processing procedure were recorded. After 24 hours,urinary function was followed up for uri-nary catheterization. Results The anesthesia effects in group Ⅱ and Ⅲ were much better than that in group I,but no significant difference was found between group Ⅱ and Ⅲ. There was no significant differ-ence in the incidence of postoperative urinary retention among group Ⅰ,Ⅱ and C,but the incidence of postoperative urinary retention and intraoperative hypotension in all these groups were lower than groupⅢ. Conclusion Subarachnoid anesthesia with 3 ml of 0. 375% isobaric bupivacaine not only meets the op-eration requirement,but also has a low incidence of urinary retention.