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创伤性膀胱损伤管理中的变异与挑战:来自大型创伤中心的经验

Variations and Challenges in the Management of Traumatic Bladder Injuries: An Experience From a Large Trauma Center.

作者信息

Nguyen Anna, Choi Se Jong, Gabriel Beshoy, Chai Stephen, Serrano Jan, Dong Fanglong, Archambeau Benjamin, Neeki Michael M

机构信息

Department of Medicine, California University of Science and Medicine, Colton, USA.

Department of Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA.

出版信息

Cureus. 2025 Apr 14;17(4):e82245. doi: 10.7759/cureus.82245. eCollection 2025 Apr.

Abstract

INTRODUCTION

Bladder trauma, often resulting from blunt or penetrating injuries, presents a significant challenge in trauma care due to its potential for serious complications and mortality. This retrospective study aimed to investigate demographic characteristics, mechanisms of injury, management strategies, and outcomes in bladder trauma patients, with a focus on comparing the differences between blunt and penetrating trauma cases.

METHODS

Data were collected from trauma patients presenting to Arrowhead Regional Medical Center between February 17, 2013, and October 30, 2022. Patients aged 18 years and older diagnosed with bladder rupture were included in the final analysis. Patient demographics, mechanisms of injury, and treatment modalities were analyzed to compare the differences in outcomes. Statistical analyses were conducted using the Statistical Analysis System software for Windows version 9.4 (SAS Inc., Cary, NC).

RESULTS

A total of 88 patients were included in the analysis. The majority of patients were men (n = 65, 73.9%), and blunt trauma accounted for 75% (n = 66) of cases. While there was a significantly higher proportion of men in penetrating trauma cases, differences in mortality, systolic and diastolic blood pressure, pulse, respiratory rate, oxygen saturation, Glasgow Coma Scale, injury severity score, and units of blood given were not statistically different between blunt and penetrating trauma cases.

CONCLUSION

There is no statistical difference in regard to outcomes between blunt and penetrating bladder trauma. Future research should aim to validate these findings in larger cohorts, explore additional factors influencing treatment decisions and outcomes, and investigate optimal management strategies to enhance patient care and minimize complications in this challenging clinical scenario.

摘要

引言

膀胱创伤通常由钝性或穿透性损伤引起,因其可能导致严重并发症和死亡,在创伤护理中构成重大挑战。本回顾性研究旨在调查膀胱创伤患者的人口统计学特征、损伤机制、治疗策略及预后,重点比较钝性创伤和穿透性创伤病例之间的差异。

方法

收集2013年2月17日至2022年10月30日期间在箭头区域医疗中心就诊的创伤患者的数据。最终分析纳入年龄在18岁及以上、诊断为膀胱破裂的患者。分析患者的人口统计学特征、损伤机制和治疗方式,以比较预后差异。使用Windows版9.4的统计分析系统软件(SAS公司,北卡罗来纳州卡里)进行统计分析。

结果

共有88例患者纳入分析。大多数患者为男性(n = 65,73.9%),钝性创伤占病例的75%(n = 66)。虽然穿透性创伤病例中男性比例显著更高,但钝性创伤和穿透性创伤病例在死亡率、收缩压和舒张压、脉搏、呼吸频率、血氧饱和度、格拉斯哥昏迷量表、损伤严重程度评分及输血量方面的差异无统计学意义。

结论

钝性和穿透性膀胱创伤在预后方面无统计学差异。未来研究应旨在在更大的队列中验证这些发现,探索影响治疗决策和预后的其他因素,并研究最佳管理策略,以改善这一具有挑战性的临床场景中的患者护理并减少并发症。

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