- 期刊
Asphyxiated Bladder Syndrome in a Pediatric Intensive Care Unit
兒科加護中心内的窒息性膀胱症侯群
摘要
在兩年期間的前瞻性研究中，於本院兒科加護中心内總共收集了16個窒息性胧胱侯群的病例。這種暂時性的膀胱異常膨涨並非因尿路有阻塞存在，而是屬於窒息的後遺症之一，以延遲自發性排尿来表现。在本院兒科加護中心内其發生率是1.9%，其中有5例是發生在婴兒時期，所有病例年龄都小於3歲（平均爲9.1個月），而發生率於此年龄群中爲2.8％。爲了使膀胱能間断性的排空，以恥骨上膀胱壓迫法（Crede操作法）全部都可成功。有些窒息性膀胱症侯群可同時随伴發生腸道功能失常，在臨床上及放射學上都表现出麻痹性腸隔(62.5%，10/6)或無氣性腹腔(l8.8%,3/16)。於這些病例中無跡象顯示本症與全身性或尿路的細菌感染有關連。除了一個早期即已死亡的病例外，所有病例的排尿功能及腸道功能最後都完全恢復正常。平均（誤差值）的膀胱失能期間為66.9(40.3)小時。分别於失能期間及恢復後，每一病兒的超音波检查均顯示其腎臟及集尿系统都有正常的结構。半数(8/16)的病人最終死亡了，而死亡都與窒息性膀胱症侯群無關。在死亡後的5例解剖探查中，並無尿路具常的發现。
關鍵字
無資料並列摘要
Sixteen neonates and infants with asphyxiated bladder syndrome (ABS) were prospectively studied over a two-year period. Their transient urinary bladder distention had developed as a sequel of asphyxial events, and presented as delayed micturition in the absence of obstructive lesion. The incidence was 1.9 percent in this Pediatric Intensive Care Unit. Five cases occurred in the neonatal period. All patients were younger than three years of age (mean: 9.1 months), and the incidence of ABS was 2.8 percent within this age group. For intermittent decompression of the bladder, all responded successfully to the suprapubic bladder expression method (Crede’s maneuver). Most (81.3%, 13/16) ABS cases coexisted with intestinal dysfunction as either paralytic ileus (62.5%, 10/16) or as gas-less abdomen (18.8%, 3/16). There was no evidence of association with either systemic or urinary bacterial infection. Normal spontaneous voiding and bowel function were regained in all cases except one, who died early. Mean (SD) duration of bladder dysfunction was 66.9 (40.3) hours. Sonography showed normal kidneys and collecting system in all patients both during and after ABS episodes. Half of the patients (8/16) died ultimately. No urinary tract abnormality was found in post-mortem examinations in five cases.