外伤性膀胱前间隙出血CT表现及与耻骨骨折相关性研究  

The study of CT findings of traumatic prevesical space hemorrhage and their correlation with pubic fracture

作　　者：张艳 袁梅 陈小军 吴建伟 ZHANG Yan;YUAN Mei;CHEN Xiaojun;WU Jianwei(Department of Medical Imaging,Qinhuai Medical area of Eastern theater General Hospital,Nanjing,Jiangsu 210002,China;Department of Medical Imaging,Taikang Xianlin Drum Tower Hospital,Nanjing,Jiangsu 210046,China)

机构地区：[1]东部战区总医院秦淮医疗区医学影像科,江苏南京210002 [2]泰康仙林鼓楼医院医学影像科,江苏南京210004

出　　处：《影像研究与医学应用》2023年第6期41-44,48,共5页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨外伤性膀胱前间隙出血CT征象及与耻骨骨折的相关性。方法:选取2018年7月—2022年4月间东部战区总医院秦淮医疗区和泰康仙林鼓楼医院收治的外伤性耻骨骨折患者39例,分析骨折部位和类型与膀胱前间隙出血的相关性,探讨膀胱前间隙出血形成的原因及出血扩展范围。结果:本研究39例患者共72处耻骨骨折,其中14例并发膀胱前间隙出血,另有1例无耻骨骨折但腹壁挫伤所致膀胱前间隙出血病人。骨折部位和膀胱前间隙出血相关性分析显示耻骨上支前部骨折是引起膀胱前间隙出血的主要原因(χ^(2)=24.2506,P<0.001),关联性分析显示耻骨上支前部骨折和耻骨上支后部骨折在膀胱前间隙出血形成中具有相关性(Z=11.73,P<0.001),耻骨上支前部骨折错位是引起膀胱前间隙出血的原因(Z=2.96,P=0.003)。15例骨折病人根据出血量不同出血扩散至膀胱前、两侧间隙及腹膜前间隙。结论:外伤性耻骨骨折可以引起膀胱前间隙大量出血,耻骨上支前部骨折错位是引起膀胱前间隙出血的主要因素,而即使没有耻骨骨折暴力冲击下腹壁也是出血的少见原因。Objective To investigate the CT signs of traumatic hemorrhage in anterior bladder space and its correlation with pubic fracture.Methods 39 patients with traumatic pubic fractures admitted to Qinhuai Medical Area of Eastern Theater General Hospital and Taikang Xianlin Drum Tower Hospital from July 2018 to April 2022 were selected,the correlation between the location and type of fracture and bleeding in anterior bladder space was analyzed,and the cause and extension of bleeding in anterior bladder space were discussed.Results There were 72 pubic fractures in 39 cases,of which 14 cases were complicated with hemorrhage of prevesical space,and 1 case of hemorrhage of prevesical space caused by abdominal wall contusion but no pubic fracture.The correlation analysis between the fracture site and the bleeding in the anterior bladder space showed that the fracture of the anterior superior pubic branch was the main cause of bleeding in the anterior bladder space(χ^(2)=24.2506,P<0.001).The correlation analysis showed that there was a correlation between the anterior pubic branch fracture and the posterior pubic branch fracture in the formation of bleeding in the anterior bladder space(Z=11.73,P<0.001),and the dislocation of the anterior pubic branch fracture was the cause of bleeding in the anterior bladder(Z=2.96,P=0.003).According to the amount of bleeding,the bleeding spread to the anterior bladder,bilateral space and preperitoneal space in 15 patients with fracture.Conclusion Traumatic pubic fracture can cause massive bleeding in anterior bladder space.Dislocation of anterior pubic branch fracture is the main cause of bleeding in anterior bladder space,and even without violent impact of pubic fracture,abdominal wall is a rare cause of bleeding.

关 键 词：膀胱前间隙 出血 耻骨骨折 计算机体层摄影 

分 类 号：R445.3[医药卫生—影像医学与核医学]