161例肾损伤的处理

目的探讨严重肾损伤的概念及治疗方案。方法对１９６５至１９９６年收治的１６１例严重肾损伤病例资料进行回顾分析。结果１６１例病人，伴有合并伤１１６例（７２．０％）。保守治疗７７例，发生并发症６例，治愈率９２．２％；手术治疗７３例，其中肾切除３２例，切肾率１９．９％；选择性肾动脉栓塞治疗１１例，治愈率１００．０％；死亡１５例，死亡率为９．３％。结论（１）强调手术治疗与非手术治疗的指征。（２）对有合并伤者，应全面、准确、及时的进行伤情评估。（３）对疑有内脏损伤者，应仔细探查，发现损伤应一并处理。

Severe renal injuries (report of 161 cases)

Ojective To evaluate the management of severe renal injury. Methods 161 cases of severe renal injuries encountered during 1965 1996 were reviewed and analyzed. Results 116 cases out of 161 (72.0%) were complicated by other organ injuries. 77 cases were managed without surgical intervention and 6 of them had complications. 73 cases were treated by open operation and 32 of them required nephrectomy.11 cases was treated with selected renal arteriographic embolism,the cure rate being 100.0%. 15 patients died of the injury (9.3%). Conclusions The following points were emphasized:(1)the most important was to decide the treatment strategy,open surgery or not.(2)the extent of the injury should be evaluated accurately and quickly.(3)concomitant injury to organs other than the kidney should not be overlooked.