B超引导下利用自制穿刺套装行膀胱 穿刺造瘘疗效观察

Clinical application of bladder puncture fistula using seldinger method and self-piercing kits under ultrasound-guided technique

摘要:

目的 评价B超引导下，利用自行组装的穿刺套件行膀胱穿刺造瘘的安全有效性及临床应用价值。方法 选取尿潴留患者53例，利用自行组装的穿刺套件Seldinger法行膀胱穿刺造瘘，并与39例按传统的耻骨上穿刺造瘘（Cook法）进行临床比较。结果 超声引导下Seldinger法组均一次穿刺成功，2例出现严重血尿，无1例腹膜、直肠等邻近脏器损伤患者，无1例发生切口感染。传统的耻骨上穿刺造瘘组3例中转开放耻骨上穿刺造瘘，3例术后严重血尿，1例穿刺针进入腹腔，1例切口感染。手术时间、住院时间、并发症发生率上Seldinger法组明显低于传统穿刺组（P <0.05），手术费用无明显差别（P >0.05）。结论 超声引导下，利用自行组合穿刺套件Seldinger法行膀胱穿刺造瘘，同传统的耻骨上膀胱造瘘（Cook法）相比较，具有操作简单、易掌握、安全可靠、手术时间短、出血少、并发症发生率低、恢复快等优点，

Abstract:

【Objective】 To evaluate efficacy and safety of clinical application of bladder puncture fistula using Seldinger method and self-piercing kits under ultrasound-guided technique. 【Methods】 The 53 cases of patients with urinary retention received puncture cystostomy, using seldinger method and self-piercing kits under ultrasound-guided technique, while 39 cases traditional bladder puncture fistula (Cook Method). 【Results】 The groups of Seldinger method were once successful, two cases of severe hematuria, no cases of peritoneal rectal injury patients and other adjacent organs, no cases of wound infection. In the groups of Cook method, 3 cases of conversion to open, three cases of severe hematuria, one case of the needle into the abdominal cavity, and one case of wound infection. The group of seldinger method was significantly lower than the traditional method on operative time, hospital stay, the incidence of complications (P <0.05), no significant difference in the cost of surgery between the two groups (P >0.05). 【Conclusion】 The operation using Seldinger method and self-piercing kits under ultrasound-guided technique is simple, easy to learn, safe and reliable, a shorter operative time, less blood loss, low incidence of complications and quick recovery compared with Cook method.