肾损伤450例的诊断和治疗

目的　提高肾损伤的诊疗水平。方法　对450例肾损伤进行了回顾性分析。结果　闭合性损伤423例,开放性损伤27例, 合并伤227例。B超阳性率68.2%,双倍剂量IVU阳性率47.9%,CT阳性率100%。根据病情分别选择手术与保守治疗,非手 术治愈365例,超选择性肾动脉栓塞4例,手术治愈67例,死亡14例。结论　B超检查快捷安全,应作为肾损伤首选检查方法, 在诊断中主要起到筛选作用。CT扫描为肾损伤程度分类和选择治疗方案提供可靠依据,应作为重度肾损伤和术前常规检查方 法。治疗取决于伤情,保守治疗是重要的治疗方法,严格掌握手术和非手术治疗指征是处理肾损伤的关键。

Diagnosis and treatment of renal trauma (report of 450 cases)

Objective To improve the diagnosis and treatment of renal trauma. Methods A retrospective analysis of 450 cases with renal trauma was performed. Results Among them, 423 had blunt renal injuries; 27 had open renal injuries; and 277 had multiple complicated injuries. The positive rate was 68.2% by B-ultrasound, 47.9% by double-dose IVU, 100% by CT. According to the severity of trauma of each patient, surgical intervention and conservative treatment were used respectively. 365 cases were cured with conservative treatment; 4 cases were cured with embolism of super-selective renal artery; 67 cases were cured with operation; and 14 cases died. Conclusion B-ultrasound is a simple, instant and safe method, and should be the first exam method and has a selective effect in the diagnosis. CT scan is the most reliable method for evaluating the severity of renal injuries and providing treatment foundation, and should be a chief exam method for patients with severe injuries before operation. The treatment depends on the severity of renal injury. The conservative treatment is an important method in most cases. It is most important to decide the treatment strategy.