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目的:探讨腹腔镜下修补腹膜内型膀胱破裂的可行性与安全性。方法:回顾分析2008年8月至2014年11月为16例腹膜内型膀胱破裂患者行腹腔镜诊治的临床资料。腹腔镜下观察膀胱破裂位置、大小、破裂口与输尿管开口的位置关系,探查有无合并腹腔其他脏器损伤。2-0可吸收线连续全层缝合膀胱破裂口,膀胱灌注含有亚甲蓝的生理盐水200 ml检查有无渗漏,必要时再次加固缝合。盆腔内留置引流管一根。结果:16例均证实为腹膜内型膀胱破裂,均于腹腔镜下用2-0可吸收线连续全层缝合膀胱破裂口,手术时间平均(58±8)min,术中失血量平均(45.0±5.5)ml。术后患者均恢复良好,术后平均住院(9.0±0.7)d,无切口感染、尿瘘、发热、肠梗阻等并发症发生。结论:腹腔镜下修补腹膜内型膀胱破裂可行、安全,并具有创伤小、痛苦小、康复快、并发症少、美容效果好等优点。
Objective: To investigate the feasibility and safety of laparoscopic repair of intraperitoneal bladder rupture. Methods: The clinical data of 16 patients with intraperitoneal bladder rupture diagnosed and treated by laparoscopy from August 2008 to November 2014 were retrospectively analyzed. Laparoscopic observation of the location of the rupture of the bladder, the size, the location of the ruptured mouth and urethral opening to explore the presence or absence of other abdominal organ damage. 2-0 absorbable line continuous full-thickness suture bladder rupture, bladder perfusion containing methylene blue 200 ml normal saline to check for leakage, if necessary, re-suture reinforcement. Pelvic indwelling a drainage tube. Results: All the 16 cases were proved to be intraperitoneal bladder rupture. All of them were sutured with 2-0 absorbable laparoscopic suture to rupture the bladder. The average operation time was (58 ± 8) min. The average blood loss during operation was 45.0 ± 5.5) ml. The postoperative patients recovered well. The mean postoperative hospital stay (9.0 ± 0.7) d, no incision infection, urinary fistula, fever, intestinal obstruction and other complications occurred. Conclusion: Laparoscopic repair of intraperitoneal bladder rupture feasible and safe, and has the advantages of less trauma, less pain, faster recovery, fewer complications, better cosmetic results.