腹腔镜治疗腹膜内型膀胱破裂20例临床经验分析

Laparoscopic surgical treatment of intraperitoneal bladder rupture: 20 cases report

目的探讨腹腔镜在处理腹膜内型膀胱破裂方面的临床应用价值。方法 20例腹膜内型膀胱破裂患者采用腹腔镜治疗,建立气腹,直视下明确膀胱破口形状、大小,并给予连续全层缝合。结果 20例均在腹腔镜下进一步明确诊断,并给予行腔镜下缝合,平均手术时间53min,平均术中失血量50mL,平均术后住院5d。20例平均随访12个月(6～18个月),术后均恢复良好,无并发症发生。结论腹腔镜处理腹膜内型膀胱破裂具有创伤小、安全、疗效肯定等优点,如合并其他腹部脏器损伤,可一并处理,可作为该类疾病的首选治疗方式。

Objective To explore the clinical value of laparoscopy in the treatment of intraperitoneal bladder rupture. Methods Twenty cases of intraperitoneal bladder rupture treated by laparoscopic surgery from July 2008 to July 2012 were retrospectively analyzed, among whom 12 cases had suffered traffic accident injuries and 5 cases had suffered violence strike in the lower abdomens, and 3 cases after transurethral surgery. Results All the 20 cases were in laparoscopic further diagnosis, and offered endoluminal suture. The mean surgical time was 53 min, the mean intraoperative blood loss was 50 mL, and the mean hospital stay was 5 d. During the medium follow-up of 12 months （6-18 months）, all patients received good recovery and no complication occurred. Conclusions Laparoscopic surgical treatment of intraperitoneal bladder rupture is less invasive, safe, effective, etc. If combined with other abdominal organ injury which can be dealt with at the same time, this treatment can be used as the first choice of this kind of disease.