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膀胱内给药治疗儿童膀胱血块

Intravesical Agents in the Treatment of Bladder Clots in Children.

作者信息

Della Corte Marcello, Clemente Erica, Cerchia Elisa, De Cillis Sabrina, Checcucci Enrico, Amparore Daniele, Fiori Cristian, Porpiglia Francesco, Gerocarni Nappo Simona

机构信息

Division of Urology, Department of Oncology, School of Medicine, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole 10, 10043 Orbassano, Italy.

Division of Pediatric Urology, Regina Margherita Hospital, 10126 Turin, Italy.

出版信息

Pediatr Rep. 2023 Apr 14;15(2):282-292. doi: 10.3390/pediatric15020024.

Abstract

Bladder blood clots represent an infrequent urinary condition in children. They usually result from hematuria with many underlying causes, such as urinary tract infections and urethral/bladder traumas. Treatment options for clot removal include trans-urethral or suprapubic bladder irrigation and, if unsuccessful, endoscopic management under general anesthesia with a resectoscope. In younger male children, however, the repeated passage of a trans-urethral resectoscope may be challenging and traumatic, due to the small lumen diameter. Eventually, an open surgical approach can be required in many patients. Few anecdotal non-surgical approaches have been proposed for the management of bladder blood clots in children. This review aims to summarize the conservative techniques described in the literature with the instillation of intravesical agents, analyzing the different strategies and their advantages.

摘要

膀胱血凝块是儿童中一种罕见的泌尿系统病症。它们通常由血尿引发,有许多潜在病因,如尿路感染和尿道/膀胱创伤。清除血凝块的治疗选择包括经尿道或耻骨上膀胱冲洗,若冲洗不成功,则在全身麻醉下使用电切镜进行内镜处理。然而,对于年幼男童,由于尿道腔直径小,反复插入经尿道电切镜可能具有挑战性且会造成创伤。最终,许多患者可能需要采用开放手术入路。关于儿童膀胱血凝块的处理,很少有非手术的经验性方法被提出。本综述旨在总结文献中描述的通过膀胱内注入药物的保守技术,分析不同策略及其优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0404/10123654/a103bb8bc71b/pediatrrep-15-00024-g001.jpg

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