外伤致肾损伤的诊治体会

目的 探讨外伤性肾损伤的诊断和治疗方法,总结诊断和治疗经验.方法 回顾分析56例外伤致肾损伤的临床资料,其中保守治疗44例,行手术治疗12例,总结和比较其临床诊断和治疗.结果 56例患者均行双肾CT及B超或彩超检查,阳性率为100%;手术组12例中有7例先经保守治疗后中转开放手术,5例急诊手术.死亡3例,均为多发伤伴休克的危重患者,余均痊愈;3个月～1年后复查BUM、Cr、CO2-CP基本恢复正常,复查B超或CT等示血肿明显或完全吸收.结论 B超和CT是诊断肾损伤的首选检查方法,轻、中度肾损伤患者如果无严重并发症,可保守治疗,在严密观察病情变化,如出血继续加重,其他合并脏器损伤未能控制,并发症加重,应行手术治疗.

Analysis of the diagnosis and treatment of renal injury by trauma

Objective To study the diagnosis and treatment of renal injuries by trauma.Methods Fifty six cases of such patient with renal injuries by trauma were analyzed retrospectively.Conservative treatment 44 cases,12 cases with surgery,the clinical diagnosis and treatment were summarized and compared.Results All cases were examined by bilateral renal CT,ultrsound and Color Ultrasound,the positive rate was 100%.In 12 cases with surgery,7 cases were all cured after inverted to open surgery,5 cases were given emergency operation.In 56 cases,3 cases of death were all for critical patients of multiple trauma with shock,and the others were cured.After 3 months or 1 year,the BUM,Cr,CO2-CP was almost recovered to normal,Ultrsound or CT reexamination showed that the hematoma were obviously or complete absorption.Conclusion Ultrsound and CT scan is a preferred examination method to diagnose renal injury.The patients of mild and moderate renal injuries can receive conservative therapy without the severe complications,Under careful monitoring,if continuous hemorrhage combined with other organs injuries,and the complication is aggravated,it needs surgical treatment.