术中尿外渗导致腹腔高压综合征的诊断及治疗  

Diagnosis and treatment of abdominal hypertension syndrome caused by urine extravasation during urological surgery

作　　者：董秉政[1] 马伟明[1] 史振铎[1] 梁清[1] 邱祥政[1] 韩从辉[1] DONG Bing-zheng;MA Wei-ming;SHI Zhen-duo;LIANG Qing;QIU Xiang-zheng;HAN Cong-hui(Department of Urology Surgery,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China)

机构地区：[1]徐州市中心医院泌尿外科,江苏徐州221000

出　　处：《中国校医》2021年第12期891-893,共3页Chinese Journal of School Doctor

基　　金：江苏省医学创新团队项目(CXTDA2017048);徐州市科技计划项目(KC19029)。

摘　　要：目的探讨泌尿外科术中尿外渗导致的腹腔高压综合征的诊断和治疗原则。方法2013年5月—2020年8月诊治泌尿外科手术中尿外渗所导致的腹腔高压综合征患者19例,均给予内科综合治疗,其中2例同时行开放手术减压,对比治疗前后心率、血压、呼吸、动脉血氧分压、尿量、肾功能和腹腔压力的变化。结果19例患者除1例死亡外,其余18例通过综合治疗均获治愈。治愈患者治疗前动脉血氧分压为(59.56±3.34)mm Hg、血肌酐为(164.94±75.10)μmol/L、尿量为(0.83±0.24)mL/(kg·h)、腹腔内压为(23.61±2.77)mm Hg;治疗后上述各指标分别为(91.61±3.32)mm Hg、(160.22±76.01)μmol/L、(1.59±0.44)mL/(kg·h)、(14.06±3.92)mm Hg。均获明显改善,(t=23.07、5.63、8.67、12.18,P值均<0.05)。结论及时的内科综合治疗和手术减压是治疗术中尿外渗导致的腹腔高压综合征的有效方法,减少术中尿外渗才能避免泌尿外科腹腔高压综合征的发生。Objective caused by urine extravasation during urological surgery.MethodsFrom May 2013 to August 2020,19 patients with abdominal hypertension syndrome caused by urinary extravasation in urological surgery were diagnosed and treated,and they were all given comprehensive medical treatment.Among them,2 cases were treated with surgical decompression at the same time.The changes in heart rate,blood pressure,respiration,arterial oxygen partial pressure,urine output,renal function,and abdominal pressure were compared before and after treatment.ResultsExcept for one death of the 19 patients,the other 18 patients were eventually cured.The arterial blood oxygen partial pressure before treatment in the cured patient was(59.56±3.34)mm Hg,blood creatinine was(164.94±75.10)μmol/L,urine output was(0.83±0.24)mL/(kg·h),and intra-abdominal pressure was(23.61±2.77)mm Hg;the above indicators were(91.61±3.32)mm Hg,(160.22±76.01)μmol/L,(1.59±0.44)mL/(kg·h),(14.06±3.92)mm Hg after treatment.All were significantly improved(t=23.07,5.63,8.67,12.18,all P values<0.05).ConclusionTimely comprehensive medical treatment and surgical decompression are effective methods to treat abdominal hypertension syndrome caused by intraoperative urine extravasation.Reducing intraoperative urinary extravasation can avoid the occurrence of abdominal hypertension syndrome in urology.

关 键 词：腹腔高压综合征 泌尿外科手术 腹腔内压 

分 类 号：R656.5[医药卫生—外科学]