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韩国骨盆创伤患者导尿前床边尿道造影方法:一例报告

A method of bedside urethrography before catheterization in pelvic trauma in Korea: a case report.

作者信息

Lee Hojun, Jeong Sung Yub, Hwang Kun

机构信息

Department of General Surgery, Armed Forces Capital Hospital, Seongnam, Korea.

Department of Plastic Surgery, Armed Forces Capital Hospital, Seongnam, Korea.

出版信息

J Trauma Inj. 2023 Dec;36(4):451-453. doi: 10.20408/jti.2023.0047. Epub 2023 Dec 20.

Abstract

We introduce a convenient method of urethrography before catheterization for patients with pelvic trauma that can be used in a resuscitation area. A 10-mL syringe without a needle was used. X-ray contrast medium (Iohexol, 300 mg I/mL) was administered through the urethral orifice using a 10-mL syringe without needle and a simple pelvic anteroposterior film was taken (70 kilovolt [peak], 50 mAs). A 36-year-old soldier with a saddle injury from a gun barrel was taken to a trauma center. He had a pelvic fracture and complained of hematuria. Bedside urethrography above described was performed. The anterior urethra showed nonspecific findings, but dye leaked from the posterior urethra. Bedside Foley catheter insertion was attempted, but the catheter could not be advanced past the membranous urethra. Thereafter, suprapubic catheterization was performed. On the day of the injury, iliac artery embolization was carried out. The dislocated sacroiliac joint was also treated using open reduction and internal fixation. On hospital day 7, guidewire Foley insertion was performed. This bedside urethrography technique is simple and useful for pelvic fractures in which urethral injury is suspected.

摘要

我们为骨盆创伤患者引入了一种在导尿前进行尿道造影的便捷方法,该方法可在复苏区使用。使用了一个不带针头的10毫升注射器。通过尿道外口使用不带针头的10毫升注射器注入X线造影剂(碘海醇,300毫克碘/毫升),并拍摄一张简单的骨盆前后位片(70千伏[峰值],50毫安秒)。一名36岁因枪管造成会阴部损伤的士兵被送往创伤中心。他有骨盆骨折并伴有血尿。进行了上述床边尿道造影。前尿道显示非特异性表现,但造影剂从后尿道漏出。尝试在床边插入Foley导尿管,但导管无法通过膜部尿道推进。此后,进行了耻骨上膀胱造瘘术。受伤当天,进行了髂动脉栓塞。脱位的骶髂关节也采用切开复位内固定治疗。在住院第7天,进行了导丝引导下的Foley导尿管插入术。这种床边尿道造影技术对于怀疑有尿道损伤的骨盆骨折简单且有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c5a/11309254/f3598700369b/jti-2023-0047f1.jpg

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