经尿道前列腺等离子剜除术中膀胱气体爆炸致膀胱破裂1例并文献复习  

Bladder Rupture Caused by Bladder Gas Explosion in Transurethral Plasma Kinetic Enucleation of the Prostate : A Case Report and Literature Review

作　　者：杨波[1] 马志芳[1] 李连鹏 赵永刚 张红斌 成凤韬[1] 苏军[1] YANG Bo;MA Zhifang;LI Lianpeng;ZHAO Yonggang;ZHANG Hongbin;CHENG Fengtao;SU Jun(不详;Binzhou Central Hospital,Binzhou 251700,China)

机构地区：[1]滨州市中心医院,山东滨州251700

出　　处：《中外医学研究》2022年第33期135-138,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨经尿道前列腺剜除术导致膀胱气体爆炸致膀胱破裂的原因,以及相应处理措施,以减少该术中并发症的发生。方法:回顾分析滨州市中心医院经尿道前列腺剜除术中导致膀胱破裂1例的诊断、治疗经过,结合文献分析膀胱爆炸的原因及处理措施。结果:该例患者手术过程中,膀胱造瘘管堵塞,冲洗膀胱造瘘管的过程中可能混入外界气体,导致膀胱气体内爆炸,爆炸导致膀胱发生破裂,手术过程中发现腹膜内破裂,给予开放手术处理。结论:经尿道前列腺等离子剜除术手术过程中发生膀胱内气体爆炸导致膀胱破裂是极为罕见的并发症,主要考虑各种原因造成一定量的空气进入了膀胱,并与膀胱内可燃气体构成一定比例后充分混合,同时由于激发电火花引发膀胱内气体爆炸,易导致膀胱发生破裂。术前行膀胱造瘘术,术中缩短手术时间,并及时有效排出膀胱内各种气体及电切膀胱颈12点处时及时排空该处气体应可避免该并发症的发生。Objective: To investigate the causes of bladder rupture caused by bladder gas explosion after transurethral enucleation of prostate and the corresponding treatment measures to reduce the occurrence of complications during the operation. Method: The diagnosis and treatment of one case of bladder rupture caused by transurethral enucleation of prostate in Binzhou Central Hospital were reviewed. The causes and treatment of bladder explosion were analyzed in combination with literature. Result: During the operation, the cystostomy tube was blocked, and the external gas might be mixed in the process of flushing the cystostomy tube, resulting in internal explosion of bladder gas, which led to rupture of bladder. Intraperitoneal rupture was found during the operation, and open operation was given.Conclusion: Bladder rupture caused by gas explosion in the bladder during transurethral plasma enucleation of prostate is a very rare complication. It is mainly considered that a certain amount of air enters the bladder due to various reasons and is fully mixed with the combustible gas in the bladder. At the same time, the gas explosion in the bladder caused by electric spark is easy to lead to bladder rupture. Preoperative cystostomy, shortening the operation time, timely and effective discharge of various gases in the bladder and timely evacuation of gases at 12 o’clock of bladder neck can avoid the occurrence of this complication.

关 键 词：经尿道前列腺等离子剜除术 膀胱破裂 气体爆炸 

分 类 号：R699.8[医药卫生—泌尿科学]