CAJ | 학술논문

目的：探讨经尿道膀胱肿瘤电切术中膀胱爆炸的原因及预防措施。方法：对2例术中发生膀胱爆炸患者资料进行回顾性分析。结果：2例均是在连续电切并使用Ellick冲洗球冲洗膀胱后，再次电切或电凝时发生膀胱内爆炸。1例发生膀胱不规则破裂，急诊行膀胱全切双侧输尿管皮肤造口术；1例黏膜破裂，肌层完好，电切镜下止血。2例患者术后恢复良好，痊愈出院。结论：膀胱爆炸发生突然，多发生在肿瘤较多且位于膀胱前壁及顶壁的患者，主要原因是在冲洗膀胱时进入了一定量的空气，在与膀胱内可燃气体充分混合达一定比例后，因电火花引发爆炸，易导致膀胱破裂。应以预防为主，及时排空膀胱内气体，操作时电切环周围尽量减少气体存留，可预防膀胱爆炸的发生。
목적：탐토경뇨도방광종류전절술중방광폭작적원인급예방조시。방법：대2례술중발생방광폭작환자자료진행회고성분석。결과：2례균시재련속전절병사용Ellick충세구충세방광후，재차전절혹전응시발생방광내폭작。1례발생방광불규칙파렬，급진행방광전절쌍측수뇨관피부조구술；1례점막파렬，기층완호，전절경하지혈。2례환자술후회복량호，전유출원。결론：방광폭작발생돌연，다발생재종류교다차위우방광전벽급정벽적환자，주요원인시재충세방광시진입료일정량적공기，재여방광내가연기체충분혼합체일정비례후，인전화화인발폭작，역도치방광파렬。응이예방위주，급시배공방광내기체，조작시전절배주위진량감소기체존류，가예방방광폭작적발생。
Objective:To investigate the causes and preventive measures of bladder explosion during transurethral resection of bladder tumor.Methods:Retrospective analysis of 2 patients with bladder explosion happened in the process of operation.Results:2 patients with intravesical explosion were happened in retransurethral resection or electric coagulation after continuous cutting and the use of Ellick bulb syringe irrigation of bladder.1 cases with bladder irregular rupture was given cystectomy bilateral cutaneous ureterostomy in emergency;1 cases with mucosa rupture and muscle layer intact was given hemostasis under electricity cut mirror.2 patients recovered well after operation,and they were discharged from hospital.Conclusion:Bladder exploded happened suddenly,and often occur in the patients with many tumors and it located in the anterior wall or the top wall of the bladder.The main reason was entered amount of air when washing bladder,when it mixed with combustible gas of bladder,then triggered the explosion if meet electric spark,it will leading to rupture of bladder easily.If we can taking preventive measures,emptying bladder gas timely,minimizing the surrounding gas retention when operating the diathermy loop,we will prevent the occurrence of bladder explosion.