管理术中膀胱损伤患者的临床案例分析

O. Kalinkina, Y. Tezikov, I. Lipatov, Maria O. Mayorova, G. Sreseli
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引用次数: 0

摘要

分析一例成功治疗术中膀胱损伤患者的临床病例。研究了 39 岁患者 S.的检查和治疗结果。在该临床病例中,造成膀胱先天性损伤的原因是儿童时期的两次膀胱手术、小骨盆的明显粘连过程以及无法预见膀胱与前腹壁焊接的不典型位置。子宫内膜异位症也可能导致明显的粘连过程,但该患者尚未得到诊断和治疗。如果及时将患者转至妇科医生处进行检查,并对盆腔器官进行超声波检查,就能发现子宫内膜异位症,及时进行治疗,避免形成需要手术治疗的巨大子宫内膜样囊肿。在这个临床病例中,我们注意到缺乏对该患者进行跨学科管理的方法,以及医务室监管方面的缺陷。尽管发生了并发症,但与泌尿科医生共同完成了手术的各个阶段,为预防子宫内膜异位症复发开出了适当的术后治疗处方,泌尿科的康复治疗使患者术后恢复良好,膀胱功能得以恢复,子宫内膜异位症的临床表现也得到了控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of a clinical case of managing a patient with intraoperative bladder injury
To analyze a clinical case of successful treatment of a patient with intraoperative bladder injury. The results of examination and treatment of patient S., 39 years old, were studied. The reasons for iatrogenic bladder injury in this clinical case were two surgeries on the bladder in childhood, a pronounced adhesive process of the small pelvis, and the inability to foresee the atypical localization of the bladder welded to the anterior abdominal wall. A pronounced adhesive process might also be caused by endometriosis, which had not been diagnosed and treated in this patient. Timely referral of the patient to a gynecologist for a check-up with ultrasound examination of the pelvic organs would have allowed to reveal endometriosis, timely treat it and avoid the formation of a large endometrioid cyst, which required surgical treatment. In this clinical case attention is drawn to the lack of an interdisciplinary approach to the management of this patient, defects in dispensary supervision. Despite the complication occurred, performing the stages of operation together with an urologist, adequately prescribed postoperative therapy for the prevention of recurrence of endometriosis, rehabilitation in the urology department made a favorable course of the postoperative period possible, bladder function was restored and clinical manifestations of endometriosis were controlled.
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