骨科英文书籍精读（187）｜骨盆损伤（7）
Imaging of the urinary tract
If there is evidence of upper abdominal injury, and the patient has haematuria, an intravenous urogram is performed to exclude renal injury. This will also show whether there is any ureteric or major bladder damage. In a case of urethral rupture, the base of the bladder may be riding high (dislocated prostate) or there may be a teardrop deformity of the bladder owing to compression by blood and extravasated urine (prostate-in-situ).
When a urethral injury is considered likely, an urethrogram should be undertaken using 25–30ml of water-soluble contrast agent with suitable aseptic technique. A film must be taken during injection of the contrast agent to ensure that the urethra is fully distended. This technique will confirm a urethral tear and will show whether it is complete or incomplete.
In a patient with possible rupture of the bladder (so long as there is no evidence of a urethral injury) a cystogram should be performed.
Types of injury
Injuries of the pelvis fall into four groups: (1) isolated
fractures with an intact pelvic ring; (2) fractures with a broken ring – these may be stable or unstable; (3) fractures of the acetabulum – although these are ring fractures, involvement of the joint raises special problems and therefore they are considered separately; and (4) sacrococcygeal fractures.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
haematuria /,hi:mə'tjuəriə, ,hem-/n. 血尿；血尿症
intravenous urogram静脉尿路造影照片
ureteric adj. 输尿管的
extravasated /ik'strævəˌset/v. （使液体，尤指血液）外渗；（血液、淋巴液等）外渗（extravasate 的过去式及过去分词）
urethrogram尿道造影照片
water-soluble contrast agent水溶性造影剂
urethra /jʊˈriːθrə/n. [解剖] 尿道
cystogram膀胱x线照片
acetabulum /ˌæsəˈtæbjʊləm/n. [解剖] 髋臼；[无脊椎] 吸盘；关节窝
sacrococcygeal骶尾的
百度翻译：
尿路成像
如果有上腹部损伤的证据，并且患者有血尿，则进行静脉尿路造影以排除肾损伤。这也将显示是否有输尿管或主要膀胱结石。在尿道破裂的情况下，膀胱底部可能高高（前列腺脱臼），或者由于血液压迫和尿液外渗（原位前列腺），膀胱可能出现泪滴状畸形。
当认为尿道可能受伤时，应使用25-30ml的水溶性造影剂和适当的无菌技术进行尿道造影。注射造影剂时必须拍一张底片，以确保尿道完全扩张。这项技术将确认尿道撕裂，并显示它是完整的还是不完整的。
对于膀胱可能破裂的病人（只要没有尿道损伤的证据），就应该做一次膀胱造影。骨盆损伤分为四类：（1）孤立性损伤骨盆环完整的骨折；（2）环断裂的骨折——可能是稳定的，也可能是不稳定的；（3）髋臼骨折——虽然是环状骨折，但关节受累会引起特殊问题，因此应单独考虑；（4）骶尾部骨折。