Aguilera Patrick A, Choi Toni, Durham Brittan A
Martin Luther King Jr./Drew Medical and Trauma Center, Charles R. Drew University of Medicine, Los Angeles, California 90254, USA.
J Emerg Med. 2004 Apr;26(3):319-21. doi: 10.1016/j.jemermed.2003.11.016.
The purpose of this article is to describe a series of patients undergoing ultrasound-guided suprapubic cystostomy catheter placement in the Emergency Department. A series of 17 consecutive patients who underwent emergent real-time ultrasound-guided suprapubic cystostomy in the ED over a 2-year period is reported. The procedure was facilitated by direct ultrasound imaging of the bladder using a Digital Sonoace 5500 machine. Procedural notes and follow-up records were analyzed for efficacy, safety, and complications. The results demonstrated that trans-abdominal ultrasound confirmed urinary retention before drainage in each of the 17 cases enrolled. Each patient required emergent suprapubic cystostomy catheter placement for acute urinary outflow obstruction because urethral bladder catheterization was not possible or was contraindicated. Continuous real-time ultrasound-guided percutaneous suprapubic cystostomy placement and decompression of the bladder was successful in all 17 (100%, 90-100% CI: 95%) cases. There were no complications reported. In conclusion, real-time ultrasound imaging of the bladder was successful for the purpose of aiding the guidance of a suprapubic cystostomy catheter placement in the ED and might represent an improvement from the standard blind method presently used.
本文旨在描述一系列在急诊科接受超声引导下耻骨上膀胱造瘘管置入术的患者。报告了在两年期间，急诊科连续17例接受紧急实时超声引导下耻骨上膀胱造瘘术的患者。使用Digital Sonoace 5500机器对膀胱进行直接超声成像，辅助完成该操作。对操作记录和随访记录进行分析，以评估其有效性、安全性和并发症情况。结果表明，在纳入的17例患者中，经腹部超声在引流前均证实存在尿潴留。由于无法进行或禁忌进行尿道膀胱插管，每位患者均因急性尿流梗阻而需要紧急进行耻骨上膀胱造瘘管置入术。连续实时超声引导下经皮耻骨上膀胱造瘘管置入及膀胱减压在所有17例（100%，90 - 100%可信区间：95%）患者中均获成功。未报告有并发症。总之，膀胱实时超声成像有助于在急诊科引导耻骨上膀胱造瘘管的置入，可能是对目前使用的标准盲目方法的一种改进。
