摘要
目的:比较经直肠超声引导前列腺神经阻滞术和直肠内灌注2%利多卡因凝胶在前列腺穿刺活检术中的镇痛疗效.方法:160例接受经直肠超声引导13点前列腺系统穿刺活检术的患者随机分为A、B两组.A组患者84例,在经直肠超声引导下,于前列腺基底部,左、右两侧精囊与前列腺交接处分别注射1%利多卡因5 ml,B组患者76例,于活检前5 min直肠内灌注2%利多卡因凝胶10 ml.采用视觉模拟评分(VAS)评估两组患者在穿刺活检术中的疼痛程度.结果:两组患者在平均年龄(t＝0.73)、PSA水平(t＝0.34)和前列腺体积(t＝0.55)的差异无显著性(P>0.05),具有可比性.A组患者VAS评分0～3分者76例,4～5分者6例,6～10分者2例.B组患者则分别为48例、18例、10例.两组患者平均疼痛评分(VAS)分别为1.2分、2.6分, 差异具有高度显著性意义(t=4.73,P<0.01).两组患者均未出现局麻药的不良反应.结论:经直肠超声引导前列腺神经阻滞术的镇痛疗效明显优于直肠内灌注2%利多卡因凝胶,值得临床推广应用.
Objective：To compare the clinical efficacy of transrectal ultrasound guided prostatic nerve blockade with intrarectal 2% lidocaine gel for pain control during transrectal prostate biopsy. Methods ：160 patients receiving systematic 13 cores biopsy of the prostate were randomized into two groups. Group A（84 cases） received an injection of 5ml 1% lidocaine into the prostatic neurovascular bundles on each side at the base of the prostate under ultrasound guidance, and group 13（76 cases） received 10 cc of intrarectal 2% lidocaine gel 5 minutes before the procedure. Pain during biopsy was assessed using a 10-point linear visual analog pain scale （VAS） immediately after this procedure. Results： The two groups were similar with respect to age,prostate-specific antigen level,and prostate olume. In group A,the VAS pain score of 0 to 3 was 76,4 to 5 was 6,6 to 10 was 2. In group 13,the VAS pain score of 0 to 3 was 48,4 to 5 was 18,6 to 10 was 10. The mean pain scores during transrectal prostate biopsy were significantly lower in group A than group 13（1.2 vs 2.6 t=4.73 ,P〈0.01）. During the study no patient in either group had any adverse effect from the injection. Conclusions ：Transrectal ultrasound guided prostatic nerve blockade provides anesthesia superior to the intrarectal lidocaine gel during transrectal prostate biopsy. We recommend its routine administration in all patients during this procedure.
出处
《中国误诊学杂志》
CAS
2005年第15期2803-2805,共3页
Chinese Journal of Misdiagnostics
