74例耻骨上膀胱穿刺造瘘术早期并发症的处理

目的：探讨耻骨上膀胱穿刺造瘘术早期并发症发生的原因及防治措施。方法：局麻下耻骨上膀胱穿刺造瘘术1600例患者中出现并发症的共74例，其中，穿刺误入腹腔3例，出血及血肿7例，尿外渗18例，改开放性手术造瘘5例，造瘘管脱落3例，膀胱刺激症状32例，感染6例，均给予相应的治疗。结果：经用不同的方法治疗，所有的并发症均获治愈或好转。结论：发生耻骨上膀胱穿刺造瘘术早期并发症的原因有解剖异常、操作失误、术前准备不充分和导尿管刺激等，正确操作、术前充分准备、术后严密观察和及时处理可以预防和治愈并发症。

Treatment and prevention of the early complications of paracentetic suprapubic cystostomy in 74 cases

Purpose:To study the cause and prevention of the early complications of paracentetic suprapubic cystostomy.Methods:Paracentetic suprapubic cystostomy was operated in local anesthesia in 1600 cases, 74 patients had complication. Injured to abdominal cavity happened in 3 cases, hemorrhage and hematoma in 7 cases, urecchysis in 18 cases, transform operating fistulization needed in 5 cases,drainage-tube came off in 3 cases, irritation sign of bladder was found in 32 cases and 6 cases had infection. All were treated by different ways.Results:All patients with complication were cured or improved by different means.Conclusions:The reasons of early complications of paracentetic suprapubic cystostomy included anatomical abnormity?operative error?inadequate preoperative preparation and irritation by catheter. Most of these complication could be prevented and cured by accurate operation,adequate preoperative preparation,close postoperative observation and timely treatment.