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頁籤選單縮合
題名 | Non-Operative Management of Bladder Rupture=膀胱破裂之非手術療法 |
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作者 | 吳季如; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 21:1 1988.01[民77.01] |
頁次 | 頁7-15 |
分類號 | 416.274 |
關鍵詞 | 膀胱破裂; 非手術療法; |
語文 | 英文(English) |
中文摘要 | 自1979年5月至1985年12月,長庚紀念醫院共經歷49例膀胱破裂的病人,其中11例祇放導尿管引統治療而成功的治癒。 本文將本院以非手術療法治療膀胱破裂所持的理由。適應症、併發症及我們對於膀胱破裂之診斷及治療方法提出報告。以非手術療法治療膀胱破裂之適應症有下列7種:1.膀胱出血已在控制之下。2.病人沒有合併尿道損傷。3.導尿管能保持通暢。4.沒有因尿路感染引發的菌血症。5.沒有其它腹部症狀需要作剖腹探查手術。6.腸子沒有經膀胱裂口凸出於膀胱內。7.病人的情況無法承受手術的危險性。我們認為如果謹慎的選擇病人,則不論其為男性或女性,腹膜內膀胱破裂或腹膜外膀胱破裂,以尿道導管留置取代傳統的手術修補是治療膀胱破裂的另一種安全、簡單、傷害及花費較少的方法。如果病人在受傷初期沒有尿路感染,則膀胱破裂的位置、尿液在體內滲出量的多少、及延置治療的時間,對治療結果並沒有顧著的影響。 |
英文摘要 | Eleven out of forty-nine cases of ruptured bladder seen at Chag Gung Memorial Hospital from May 1979 to December 1985 were successfully treated solely by urethral catheter drainage with satisfactory results. This study is to report the rationale, indication and complication of non-operative management of bladder rupture at our hospital and outline our present methods of diagnosis and treatment of major bladder trauma. Seven indications given for non-operative management of bladder rupture were: 1) Vesical hemorrhage under control 2) Exclusion of urethral injury 3) Assured patency of indewelling catheter 4) No indication of urinary tract induced sepsis 5) No other indications for abdominal surgery 6) No protrusion of intestine through the bladder tear could be identified 7) Patient with intolerable high operative risk. It is suggested that in well selected patients, urethral catheter drainage is a safe, simple, effectiye and less invasive alternative for treating either intraperitoneal or extraperitoneal bladder rupture. The degree of contrast medium extravasation in retrograde cystogram, the location of bladder rupture, the interval between injury and initiation of treatment do not determine the outcome. |
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