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影像引导下耻骨上膀胱管插入术:549 例患者护理经验。

Imaging-guided suprapubic bladder tube insertion: experience in the care of 549 patients.

机构信息

Department of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit St., White 270, Boston, MA 02114, USA.

出版信息

AJR Am J Roentgenol. 2011 Jan;196(1):182-8. doi: 10.2214/AJR.10.4520.

Abstract

OBJECTIVE

Symptomatic bladder outlet obstruction and neurogenic bladder are common conditions that frequently necessitate suprapubic insertion of a bladder tube. The purpose of this study was to describe an experience with minimally invasive imaging-guided percutaneous suprapubic bladder tube placement and the clinical and technical success and complications encountered.

MATERIALS AND METHODS

A total of 585 primary suprapubic bladder tube insertions and 439 exchanges of suprapubic bladder tubes were performed on 549 patients (469 men, 80 women; mean age, 66 years; range, 15-106 years). The details of percutaneous tube placement (indication, tube type, size at insertion and change, and method of insertion) were retrospectively recorded.

RESULTS

The technical success rate for primary suprapubic bladder tube insertion was 99.6% (547/549) and for exchanges was 92.3% (405/439). The clinical success rate for primary insertion was 98.1% (572/583), and symptoms were unresolved in 1.9% (11/583). Minor complications occurred in 7.2% (42/583) of cases at tube insertion and in 4.8% (21/439) at exchange. There was one major complication (a patient needed surgery because the small bowel was traversed by a catheter), and there was no procedure-related mortality.

CONCLUSION

Radiologic imaging-guided percutaneous suprapubic bladder tube placement is a safe and effective procedure.

摘要

目的

有症状的膀胱出口梗阻和神经性膀胱是常见的病症,常需要经耻骨上方插入膀胱管。本研究旨在描述微创影像引导经皮耻骨上膀胱管置管的经验,并介绍所遇到的临床和技术成功率及并发症。

材料与方法

549 名患者(469 名男性,80 名女性;平均年龄 66 岁;年龄范围 15-106 岁)共进行了 585 次原发性耻骨上膀胱管插入和 439 次耻骨上膀胱管更换。回顾性记录了经皮置管的详细信息(适应证、管型、插入和更换时的大小以及插入方法)。

结果

原发性耻骨上膀胱管插入的技术成功率为 99.6%(547/549),更换的技术成功率为 92.3%(405/439)。原发性插入的临床成功率为 98.1%(572/583),1.9%(11/583)的患者症状未缓解。在管插入时,7.2%(42/583)的病例发生轻微并发症,在更换时,4.8%(21/439)的病例发生轻微并发症。有 1 例严重并发症(因导管穿过小肠,患者需要手术),无与手术相关的死亡。

结论

放射影像学引导经皮耻骨上膀胱管置管是一种安全有效的方法。

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