多发伤中肾脏损伤的诊治(附62例报告)

目的探讨在多发伤中肾脏损伤的诊治方法。方法对1991年～2003年间对我院收治的62例多发伤中肾脏损伤进行回顾性分析。保守治疗28例(占45.2%),行肾切除22例,切肾率64.7%。结果肾修补8例,除4例严重损伤死亡外,其余救治成功。结论多发伤的治疗首先是抢救生命,对肾损伤仍以保守治疗为主。术前来不及行相关检查而行剖腹探查术是肾切除率增高的原因之一。

Diagnosis and mangement of renal injury in multiple injury

Objective To study the diagnosis and management of renal injury multiple injury.Method Retrospective review of 62cases of renal injury in multiple injury from1991to2003in our hospital.Renal injury in multiple injury accompanied with injury of spleen in19,hepatic injury in9,pelvic fracture and limb fracture and spinal fracture in29,thoracic injury in10,diaphrag-mic injury in2,head injury in11,intestine injury in4,pancreas injury in2.About renal injury,22cases had type I injury,in type II19,in type III19,in type IV2,with hematuria in59.Results28cases(45.2%)received non-operative management.22cases(64.7%)were treated by nephrectomy and8cases received renal suture.Treatmenthas been successful in all except 4cases who died of seri-ous injuries.Con clusion The first aid of multiple trauma is life support.Most renal injury patients were treated non-operatively.One of the reasons of high nephrectomy rate is laparotomy with no special preoperativel examination.