33例创伤性膀胱破裂的临床诊治

Diagnosis and treatment of traumatic bladder rupture in 33 cases

目的 探讨创伤性膀胱破裂的诊治方法。方法 回顾性分析 33例创伤性膀胱破裂患者的临床资料。本组 32例患者行手术治疗 ,手术包括膀胱修补术、膀胱造瘘术 ;对合并后尿道损伤者 ,根据受伤时间行相应处理 ;对肠破裂或膀胱直肠贯通伤者行肠修补或结肠造瘘术。 1例行保守治疗 ,留置导尿管引流。结果 32例手术治疗患者术后排尿正常 ,其中 1例因损伤严重于术后 2 4小时内死亡。结论 膀胱灌注实验结合腹腔穿刺检查及膀胱逆行造影是膀胱破裂简单而可靠的诊断方法。早期诊断、及时救治是救治成功的关键。

Objective To explore the diagnosis and treatment of traumatic bladder rupture.Methods A retrospective study was made on the clinical data of 33 cases with traumatic bladder rupture.Thirty-two cases were treated surgically with bladder repair and cystostomy.Those with rupture of the posterior urethra were managed according to different injury time,and those with intestinal rupture or vesicorectal penetrating wound were treated with intestinal repair or colostomy.Of all the cases,1 case was managed conservatively with indwelling catheter.ResultsThirty-two cases recovered with normal miction,and 1 case died within 24 hours after operation due to severe injury.Conclusions Bladder irrigation combined with abdominal paracentesis and retrograde radiography of the bladder are simple and reliable ways for the diagnosis of traumatic bladder rupture.Early diagnosis and timely treatment is very importment for the management of traumatic bladder rupture.