经尿道前列腺电切术中膀胱爆炸2例并文献复习

Two cases of intravesical explosion during transurethral resection of prostate and literature review

目的:分析经尿道前列腺电切术(TURP)术中膀胱爆炸的原因,探讨治疗方法及预防措施。方法:对TURP发生术中膀胱爆炸的2例病例的临床资料经行回顾性分析。结果:2例均发生膀胱不规则破裂但腹膜完整,予开放手术修补膀胱,术后均恢复良好,痊愈出院。结论:TURP术中膀胱爆炸为极罕见并发症,发生突然,严重的可致膀胱破裂。主要原因为术中电切组织时产生可燃性气体及外界空气进入膀胱,当膀胱中气体混合至一定比例,加之电火花引发膀胱爆炸。减少膀胱内气体积聚、及时排出膀胱内气体、缩短电切术时间,可减少此类事件发生。

Objective:To analyze the reasons of intravesical explosion during transurethral resection of prostate(TURP) and investigate the treatments and preventions.Methods:Data of 2 cases of intravesical explosion during TURP in our hospital were reviewed.Results:Both of the explosions led to irregular vesical rupture with complete peritoneum.They received repair of ruptured bladder and recovered well.Conclusions:Intravesical explosion during TURP happens rarely and uxexpectedly.It may result in rupture of bladder.The cause is that the explosive gases formed in the bladder mixed with air are ignited by electric sparks.Reducing the accumulation of gas.removing it timely and shortening the operation time may reduce its incidence rate.