Baerveldt M C, Klein W R
Vakgroep Algemene Heelkunde en Heelkunde der Grote Huisdieren, Utrecht.
Tijdschr Diergeneeskd. 1991 Mar 1;116(5):221-8.
It is well documented that the incidence of rupture of the urinary bladder or urachus is highest in newborn male foals and occurs during the (usually uncomplicated) parturition. Important clinical symptoms include frequent passing of small quantities of urine, abdominal distention and positive abdominal undulation. Hyperkalaemia, hyponatraemia, hypochloraemia and an elevated serum creatinine level are often present. The serum blood urea nitrogen concentration may be normal or only slightly elevated. The creatinine concentration in the peritoneal fluid is invariably higher than that in serum, and this finding is of importance in the diagnosis. A method for field diagnosis of bladder rupture is to instill a sterile solution of a dye into the bladder followed by its retrieval in the peritoneal fluid. Surgical treatment is indicated as soon as possible after diagnosis. Prior to inducing anaesthesia (oxygen, nitrous oxide and halothane by mask), fluid losses and electrolyte imbalance should be corrected and slow decompression of the abdomen should be performed in order to reduce the risk of cardiac dysrhythmias and hypovolaemic shock. The bladder defect is usually closed in two layers of inverting continuous sutures. If the diagnosis of bladder rupture is timely established, its prognosis is usually favourable.
有充分文献记载,新生雄性马驹膀胱或脐尿管破裂的发生率最高,且发生在(通常无并发症的)分娩过程中。重要的临床症状包括频繁排出少量尿液、腹胀和腹部波动阳性。常出现高钾血症、低钠血症、低氯血症和血清肌酐水平升高。血清血尿素氮浓度可能正常或仅略有升高。腹腔液中的肌酐浓度总是高于血清中的肌酐浓度,这一发现对诊断很重要。膀胱破裂的现场诊断方法是向膀胱内注入无菌染料溶液,然后在腹腔液中找回。诊断后应尽快进行手术治疗。在诱导麻醉(通过面罩给予氧气、一氧化二氮和氟烷)之前,应纠正液体丢失和电解质失衡,并缓慢进行腹部减压,以降低心律失常和低血容量性休克的风险。膀胱缺损通常用两层连续内翻缝合关闭。如果膀胱破裂的诊断及时确立,其预后通常良好。