一名因未经治疗的良性前列腺增生导致慢性尿潴留而发生尿脓毒症性弥散性血管内凝血的患者，在插入Foley导尿管后出现危及生命的尿道出血。
Life-threatening urethral hemorrhage after placement of a Foley catheter in a patient with uroseptic disseminated intravascular coagulation due to chronic urinary retention induced by untreated benign prostatic hyperplasia.
作者信息
Ikegami Yukihiro, Yoshida Keisuke, Imaizumi Tsuyoshi, Isosu Tsuyoshi, Kurosawa Shin, Murakawa Masahiro
机构信息
Department of Anesthesiology School of Medicine Fukushima Medical University Fukushima Japan.
出版信息
Acute Med Surg. 2016 May 3;3(4):407-410. doi: 10.1002/ams2.209. eCollection 2016 Oct.
CASE
A 77-year-old man with severe septic disseminated intravascular coagulation following urinary infection was transported to our hospital. He had developed urinary retention induced by untreated prostatic hyperplasia. Immediate drainage with a Foley catheter was successfully carried out, but the hematuria progressed to life-threatening hemorrhage.
OUTCOME
Complete hemostasis was impossible by surgical treatment because the tissue around the prostatic urethra was very fragile and hemorrhagic. Organized treatments (continuous hemodiafiltration combined with polymyxin-B immobilized fiber column hemoperfusion and systemic treatment with antibiotics and coagulation factors) were commenced soon after the operation. The patient eventually recovered from the septic disseminated intravascular coagulation.
CONCLUSION
This case report illustrates the risk of placement of Foley catheters in patients with severe septic disseminated intravascular coagulation.
病例
一名77岁男性因尿路感染后出现严重脓毒症性弥散性血管内凝血被送至我院。他因前列腺增生未治疗导致尿潴留。立即成功置入了Foley导尿管进行引流，但血尿进展为危及生命的出血。
结果
由于前列腺尿道周围组织非常脆弱且易出血，手术治疗无法实现完全止血。术后不久即开始进行综合治疗（持续血液透析滤过联合多黏菌素B固定纤维柱血液灌流以及使用抗生素和凝血因子进行全身治疗）。患者最终从脓毒症性弥散性血管内凝血中康复。
结论
本病例报告说明了在严重脓毒症性弥散性血管内凝血患者中置入Foley导尿管的风险。
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