Rosseland L A, Bentsen G, Hopp E, Refsum S, Breivik H
Department of Anaesthesiology, Rikshospitalet University Hospital, N-0027 Oslo, Norway.
Acta Anaesthesiol Scand. 2005 Nov;49(10):1456-9. doi: 10.1111/j.1399-6576.2005.00817.x.
Post-operative urinary retention (PUR) is associated with a risk of over-distension and permanent detrusor damage. The prevention of PUR by routine catheterization may increase the risk of urinary tract infection. Post-operative monitoring of the bladder volume is a reliable method in adults, but has not been evaluated for reliability in children.
Forty-eight patients who, according to current clinical guidelines, required urinary bladder emptying were scanned before catheterization using the Bladderscan. Volumes estimated with ultrasound were compared with volumes measured after emptying the bladder with a catheter. Bladder emptying was controlled by concomitant fluoroscopy in 20 children.
The mean difference between the ultrasound estimates and the catheter-emptied urine volumes was 4 ml [standard deviation (SD) = 25 ml] in 26 children above the age of 3 years and -18 ml (SD = 19 ml) in 22 younger children. In the subpopulation in whom complete bladder emptying could be confirmed by fluoroscopy (14 children; median age, 3 years; range, 1-11 years), the mean difference between the ultrasound estimates and the catheter-emptied volumes was -11 ml (SD = 24 ml).
This study confirms agreement between the ultrasound scanner estimates of urinary bladder volume and the urine volume measured by emptying the bladder. Reliability was good in children above the age of 3 years. The volume was underestimated in younger children. Thus, routine monitoring of urinary bladder volume with an ultrasound scanner is a non-invasive, pain-free and reliable way of preventing over-distension of the urinary bladder in children after surgery and other procedures under general anaesthesia.
术后尿潴留（PUR）与膀胱过度扩张及永久性逼尿肌损伤风险相关。常规导尿预防PUR可能会增加尿路感染风险。膀胱容量的术后监测在成人中是一种可靠方法，但在儿童中的可靠性尚未得到评估。
根据当前临床指南需要排空膀胱的48例患者，在导尿前使用膀胱扫描仪进行扫描。将超声估计的容量与用导尿管排空膀胱后测量的容量进行比较。20名儿童通过同步荧光透视法控制膀胱排空。
26名3岁以上儿童超声估计值与导尿管排空尿量的平均差异为4 ml [标准差（SD）= 25 ml]，22名年龄较小儿童的平均差异为-18 ml（SD = 19 ml）。在通过荧光透视法可确认膀胱完全排空的亚组（14名儿童；中位年龄3岁；范围1 - 11岁）中，超声估计值与导尿管排空容量的平均差异为-11 ml（SD = 24 ml）。
本研究证实了超声扫描仪对膀胱容量的估计与排空膀胱测量的尿量之间具有一致性。3岁以上儿童的可靠性良好。年龄较小儿童的容量被低估。因此，超声扫描仪常规监测膀胱容量是预防儿童术后及全身麻醉下其他手术过程中膀胱过度扩张的一种无创、无痛且可靠的方法。
