闭合性肾损伤的诊断和外科治疗

目的　总结十年间对 2 2 5例闭合性肾损伤的诊断方法和外科治疗处理经验。方法　用B超、IVU和CT进行急诊检查 ,诊断符合率分别为 89.31%、6 5 .31%及 10 0 %。结果　肉眼血尿 135例 (6 8.18% ) ,有合并伤 79例 (35 .11% ) ,休克 36例 (16 % )。手术治疗 15 6例 ,保守治疗 6 9例 (71.11% )。 2 17例痊愈 ,死亡 8例。术后出现尿瘘 8例 ,再发血尿 5例 ,肾周血肿 3例。结论　血尿轻重与损伤程度不完全一致。诊断上应首选B超和CT检查。治疗方法的选择主要取决于肾脏损伤程度的评估。

Diagnosis and surgical treatment of blunt renal trauma

Objective To summarize the experience of diagnosis and treatment of 225 patients with blunt renal trauma over the past 10 years. Methods Emergency examination was done with B-ultrasonography, IVU and CT. The accuracy of diagnosis was 8931%, 6531% and 100% respectively. Results Among the 225 patients, 135 (68.18%), 79 (35.11%) and 36 (16%) were carriers of hematuria, coexistent injuries of other organs, and shock, respectively. 156 cases accepted surgical treatment, 69 cases accepted non-surgical treatment. 217 cases recovered, 8 cases died. The number of patients with urinary leak, hematuria recrudescence, and hematic cyst around the renal were 8, 5, and 3, respectively. Conclusions The severity of renal trauma is not completely correlated with the degree of injury. Ultrasonic and CT exam should be considered first for diagnosis.The choice of the plan depends mainly on the severity of the injury to kidney.