Marx F J, Schmiedt E
MMW Munch Med Wochenschr. 1979 Dec 7;121(49):1649-53.
The principal advantages of suprapubic drainage of the bladder compared with the transurethral indwelling catheter are to be seen in holding back ascending infection of the urinary tract and avoidance of urethral trauma. In addition to relieving the bladder in subvesical obstructions the most important indication in practise is continuous drainage of urine in patients in intensive care. With strict observation of puncture technique and contraindications (contracted bladder, tumors in the lower abdomen, bladder carcinoma, macrohematuria and hemorrhagic diathesis) the entire complication rate is 4.3% (2.3% macrohematuria, 1.5% local infection, 0.5% peritoneal lesion). With the introduction of the disposable puncture systems the suprapubic bladder fistula has become a superior alternative to the indwelling catheter in many cases.
与经尿道留置导尿管相比,耻骨上膀胱引流的主要优点在于可防止泌尿系统上行感染并避免尿道创伤。除了缓解膀胱下梗阻外,在实际应用中最重要的适应证是重症监护患者的持续尿液引流。严格遵守穿刺技术和禁忌证(膀胱挛缩、下腹部肿瘤、膀胱癌、大量血尿和出血素质),总的并发症发生率为4.3%(大量血尿2.3%、局部感染1.5%、腹膜损伤0.5%)。随着一次性穿刺系统的引入,耻骨上膀胱造瘘在许多情况下已成为留置导尿管的更佳替代方法。