目的探讨非全身麻醉肌肉松弛状态下经尿道膀胱肿瘤电切术中闭孔神经反射的防治措施。方法 167例膀胱侧壁肿瘤患者在硬膜外麻醉下实施经尿道膀胱肿瘤电切术治疗,术中采用减小电切功率、疲劳疗法、短促疗法、减少膀胱灌注量等方法减轻或避免闭孔神经反射发生;对闭孔神经反射强烈者,术中改行全身麻醉并加用肌肉松弛药控制闭孔神经反射。结果本组闭孔神经反射发生率54.5%;患者均顺利完成手术,无膀胱穿孔等严重并发症发生。结论多数膀胱侧壁肿瘤可通过非全身麻醉肌肉松弛下安全实施经尿道膀胱肿瘤电切术;术中减少或避免闭孔神经反射可有效预防膀胱穿孔、急性腹膜炎、盆腔血管损伤、肠管损伤等严重并发症。 Objective To investigate the prevention and treatment of obturator nerve reflex in transurethral resection of bladder tumor under non-general anesthesia in muscle relaxation. Methods One hundred and sixty-seven patients with bladder tumor undergoing transurethral resection of bladder tumor under epidural anesthesia were treated with the methods of reducing the power of cutting, fatigue therapy, short-term therapy and reducing the amount of bladder perfusion to reduce or avoid obstruction Nerve reflex occurs; obturator nerve reflex strongly, intraoperative conversion to general anesthesia and muscle relaxants plus closed oblate nerve control. Results The incidence of obturator nerve reflex in this group was 54.5%. All patients had successful operation and had no serious complications such as bladder perforation. Conclusions Most of the bladder tumor can be safely transurethral resected bladder tumor by non-systemic anesthesia muscle relaxation. Intraoperative reduction or avoid of obturator nerve reflex can effectively prevent bladder perforation, acute peritonitis, pelvic vascular injury, bowel injury and other serious complication.