创伤性膀胱破裂的诊断与治疗(附20例报告)

Diagnosis and treatment of traumatic bladder rupture(report of 20cases)

目的探讨创伤性膀胱破裂的诊治方法。方法结合文献对本院自1992～2001年期间的20例创伤性膀胱破裂进行了分析。其中膀胱测漏试验阳性6例,膀胱逆行造影确诊11例,腹腔穿刺阳性5例,6例复合伤病人行CT扫描发现膀胱破裂,剖腹探查确诊2例。所有病人行膀胱修补术。结果19例术后排尿功能正常,1例术后出现尿潴留。结论CT诊断创伤性膀胱破裂优于膀胱逆行造影。膀胱修补仍是治疗膀胱破裂的主要方法,腹膜外型膀胱破裂行非手术的保守治疗需慎重。

Objective To explore the methods of diagnosis and treatment of traumatic rupture of bladder.Meth ods Combined with literature review,20cases of traumatic rupture of bladder during1992～2001were studied.6cases showed the positive results by the test of bladder irrigation.11cases were comfirmed by performance of retrograde cystogram.5cases showed the positive results by abdominal paracen-tesis.6cases underwent CT cystography,and2cases were revealed bladder rupture by exploratory laparotomy.All patients underwent bladder repair.Re sults All patients had normal micturition except postoporative retention of urine in1case.Con clu sion CT has advantages over retrograde cystogram in diagnosing traumatic bladder rupture.Bladder repair is the principle approach to manage bladder rupture,while non-operative management of extraperitoneal bladder rupture should be prudent.[