闭合性肾损伤的诊治分析(附32例报告)

目的 探讨闭合性肾损伤的诊断及治疗。方法 对32例闭合性肾损伤病例的临床表现及诊治方法进行分析。结果 32例病人中30例出现血尿。5例行大剂量IVU检查，3例有异常发现。10例行CT检查均发现异常。27例行保守治疗，除1例死于脑损伤外，余全部治愈。手术探查5例，肾脏仅为挫伤2例，肾裂伤行修补术2例，1例肾粉碎伤行肾切除。结论 肾损伤后血尿为主要临床表现。IVU及CT为主要的诊断手段。治疗方法的选择应根据肾损伤后血流动力学变化以有有无合并症决定。

Diagnosis and management of blunt renal trauma(a report of 32 cases)

Objective To discuss the the diagnosis and managment of blunt renal trauma.?Methods The manifestation?diagnosis and management of blunt renal trauma in 32 patients were analysed.?Results Hematuria was obvious in 30 patients. A large dose excretary urogram revealed abnormal findings in 3 of the 5 patients examined. Renal trauma was evaluated by CT in 10 patients and the abnormal manifestation were obvious in all cases.Twenty seven patients were successfully treated conservatively except one who died of serious craniocerebral injuries. Surgical exploration was conducted in 5 patients, in 4 of which there were concomitant intra abdominal injuries. Nephrotomy was carried out in 1 patient.?Conclusion Hematuria was primary manifestation of renal trauma. IVU and CT scanning are the principal means of diagnosis. The method of therapy was selected according to the variation of hemodynamics and the presence or absence of complications.