经尿道切除术中膀胱内气体爆炸荟萃分析(附1例报告)

A case of intravesical explosion during transurethral endoscopic procedure and review of the literatures

目的探讨膀胱内气体爆炸临床表现、发生机理、治疗及预防。方法结合报道的病例,在中国期刊全文数据库中检索1990-2010年的文献报道进行荟萃分析。结果共总结膀胱内气体爆炸22例,其中经尿道膀胱肿瘤电切术5例,经尿道前列腺切除术17例,爆炸后膀胱镜检查未发现膀胱破裂9例,膀胱全层破裂12例,11例行手术修补而愈,10例仅留置尿管而愈。结论膀胱内气体爆炸是经尿道切除手术的严重并发症,可产生膀胱破裂,可能需手术修补。术中应尽量减少空气进入膀胱和及时排出空气是预防膀胱爆炸的重要措施。

ObjectiveTdiscussthecinica1manifestatinsatigydiagnsistratmentandpreventinfintravesicaexpsinsduringtransurethral endoscopic procedures. Methods One ease was selected from our hospital. And others bad been diagnosised and reported in China from 1990 to 2010 in CNKI. All were analyzed retrospectively. Results In China 22 cases were reported, who were diagnosed ＂intravesical explosions＂ during transurethral endoscopic procedures. 5 eases occurred in TURBT, 17 cases occurred in xansurethral resection of prostate. The intravesical explosions led to 12 cases of bladder rupture. 11 cases of them received surgical correction. 1 case of them was managed by urethral catheterization alone. Conclusion Intravesical explosions are severecomplications during transurethral endoscopic procedures. They can lead to bladder rupture which usually requires surgical correction. Reducing the introduction of air and exhausting the air in time are important measures to prevent this complication.