肾损伤300例临床分析

为探讨肾损伤的诊断与治疗方法，作者对300例肾损伤进行了回顾性分析。其中闭合性损伤274例（91．3％），开放性损伤26例（8．7％）；合并伤123例（41％）；伴失血性休克56例（18．7％）。常规剂量IVU阳性率48．7％，双倍剂量IVU阳性率90．9％，B超阳性率79．3％，CT阳性率95．7％；非手术治愈185例，死亡14例。研究结果表明，B超可作为初步判断肾脏伤情最便捷的检查；CT检查准确快速，能正确显示肾脏伤情；治疗主要取决于伤情，保守治疗是重要的治疗方法；手术经腹 探查切口利于腹腔脏器探查及伤肾处理；早期处理中及时纠正休克、预防严重并发症的发生极为重要。

CLINICAL ANALYSIS OF 300 CASES OF RENAL TRAUMA

To investigate the diagnosis and treatment of renal trauma, a retrospective analysis of 300 patients with renal trauma was carried out. Among them, 274 (91 3%) had blunt renal injuries and 26 (8 7%) had penetrating injuries; 123 (41%) had multiple complicated intraabdominal injuries and 56 (18%) had concomitant shock. The positive rate was 48 7% by regular dose IVU examination and 90 9% by double dose IVU, 79 3% by ultrasonography, and 95 7% by CT. One hundred and eighty five patients were cured by conservative treatment. Fourteen patients died. B ultrasound could be conveniently used for primary assessment of renal injuries, while CT showed rapid and accurate condition of a renal trauma patient. The treatment depends on the severity of the injury. The conservative treatment was employed in most cases which present slight or moderate injury with no evident massive bleeding. Severe injury required surgical exploration. The operative approach was done through a transabdominal incision, which made it relatively easy to explore the abdominal contents and to manage the injured kidney. It was also very important to control shock and prevent other severe complications in the early stage of the treatment.