Heyns C F, Rimington P D
Department of Urology, Tygerberg Hospital, South Africa.
Br J Urol. 1987 Sep;60(3):217-22. doi: 10.1111/j.1464-410x.1987.tb05486.x.
A group of 20 patients with intraperitoneal rupture of the bladder was compared with a group of 20 patients with haematuria due to renal injury. In patients admitted to hospital within 24 h of sustaining an intraperitoneal bladder rupture, the mean serum levels of creatinine and potassium were increased and the mean serum sodium level was decreased. However, the individual serum creatinine values were within normal limits in six of the 11 patients in this group. Patients presenting more than 24 h after intraperitoneal bladder rupture had an increased mean serum urea, creatinine and potassium level and a decreased mean serum sodium and CO2 content. The individual serum urea and creatinine values on admission to hospital were higher than normal in all nine patients in this group but the serum urea/creatinine ratio was not significantly elevated. A dramatic decrease in serum urea and creatinine levels was seen within 24 h after laparotomy and suturing of the bladder rupture. In patients with abdominal symptoms and signs, haematuria and the biochemical features of renal failure (elevated serum urea, creatinine and potassium, decreased serum sodium and CO2 content), the clinician should suspect an intraperitoneal rupture of the bladder.
将一组20例膀胱腹膜内破裂患者与一组20例肾损伤所致血尿患者进行了比较。在腹膜内膀胱破裂后24小时内入院的患者中，血清肌酐和钾的平均水平升高，血清钠的平均水平降低。然而，该组11例患者中有6例的个体血清肌酐值在正常范围内。腹膜内膀胱破裂后24小时以上就诊的患者，血清尿素、肌酐和钾的平均水平升高，血清钠和二氧化碳含量的平均水平降低。该组9例患者入院时的个体血清尿素和肌酐值均高于正常，但血清尿素/肌酐比值无明显升高。膀胱破裂剖腹手术并缝合后24小时内，血清尿素和肌酐水平显著下降。对于有腹部症状和体征、血尿以及肾衰竭生化特征（血清尿素、肌酐和钾升高，血清钠和二氧化碳含量降低）的患者，临床医生应怀疑膀胱腹膜内破裂。
