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目的:研究局部表面麻醉在逆行输尿管硬镜治疗输尿管结石中的可行性。方法:收集逆行硬性输尿管镜治疗输尿管结石3637例。分为采用持续硬膜外麻醉、骶麻或腰麻称为椎管内麻醉(IA)阶段和基本采用局部麻醉(LA)辅以镇痛剂(盐酸哌替啶)阶段。回顾性分析两者在1次手术成功率、手术并发症、麻醉并发症、疼痛评分、麻醉耐受(有效性)、手术时间,疾病治疗时间、可比的治疗费用等并进行比较。结果:在麻醉耐受度、手术成功率、手术时间、手术并发症等方面二者无明显差异(P>0.05)。而在疼痛评分、疾病治疗时间、可比的治疗费用有显著差异,LA组的疼痛评分较IA组高(P<0.05),麻醉并发症发生率、治疗时间和可比治疗费用LA组远低于IA组(P<0.01)。结论:局部表面麻醉下逆行输尿管硬镜治疗输尿管结石可以作为一种较为安全、有效、可行、治疗费用低廉的方法,术中疼痛可一定程度降低手术并发症。
Objective: To study the feasibility of local surface anesthesia in the treatment of ureteral calculi with retrograde ureteroscopic treatment. Methods: The retrograde rigid ureteroscopic treatment of 3637 cases of ureteral calculi. Divided into continuous epidural anesthesia, sacral or spinal anesthesia known as spinal anesthesia (IA) phase and the basic use of local anesthesia (LA) supplemented with analgesics (pethidine hydrochloride) stage. Retrospective analysis of the two in a surgical success rate, surgical complications, anesthesia complications, pain scores, anesthesia tolerance (effectiveness), operation time, disease treatment time, comparable treatment costs and compared. Results: There was no significant difference between the two groups in anesthesia tolerance, operation success rate, operation time and surgical complications (P> 0.05). Pain score, disease treatment time, comparable treatment costs were significantly different LA pain score was higher than the IA group (P <0.05), the incidence of anesthesia complications, treatment time and comparable treatment costs LA group was far below IA Group (P <0.01). CONCLUSION: Retrograde ureteroscopic ureteroscopic ureteral calculi under topical anesthesia can be used as a safe, effective, feasible and inexpensive method to treat ureteral calculi. Intraoperative and postoperative pain can reduce the complications of surgery.