82例闭合性肾脏损伤诊治分析

目的探讨闭合性肾脏损伤诊断和治疗的方法。方法对收治的82侧创伤性闭合性肾脏损伤的临床资料进行回顾分析。结果82例中出现血尿者69例（84．1％），合并休克者21例（25、6％），伴有其他部位损伤者45例（54、9％）。80例行CT检查明确损伤程度。非手术治疗63例（76．8％），手术18例（21．9％），其中肾切除10例，肾修补8例。死亡1例。结论中、重度闭合性肾脏损伤患者伤后应尽可能选择CT检查，明确肾脏损伤程度及是否合并其它脏器损伤。闭合性肾脏损伤治疗以非手术为主，治疗期间严密观察病情进展，如非手术治疗无效应及时行手术探查治疗。

Analysis of the Diagnosis and Treatment of 82 Cases with Closed Kidney Injury

Objective To discuss the diagnosis and treatment of closed kidney injury.Methods A retrospective analysis was made to the clinical data of 82 cases with closed kidney injury.Results Out of the 82 cases,69 cases had hematuria(84.1%),21 cases complicated with shock(25.6%),45 cases had injury in other parts of the body(54.9%).CT scanning was made to determine the injury degree.63 cases received non-surgical treatment(76.8%),in 18 cases receiving operation(21.9%),10 cases received nephrectomy,8 cases received kidney repair and 1 patient died.Conclusion CT scanning should be made for patients with midrange and severe kidney injury so as to determine the injury degree and if there exists injury of other organs.Non-surgical treatment is more often adapted for closed kidney injury,but close observation should be made to the disease progress so as to decide if operation is needed.