闭合性肾损伤的诊断和治疗

Diagnosis and Treatment of Closed Renal Trauma(Report of 205 Cases)

目的探讨闭合性肾损伤的诊断与治疗方法。方法对205例闭合性肾损伤的临床资料进行回顾性分析。结果205例闭合性肾损伤中,肾挫伤113例,肾裂伤67例,肾碎裂伤31例,肾蒂血管伤12例,合并伤81例(39.5%)。血尿18例(91.7%),血尿是主要的临床症状。B 超检查199例,其中165例(82.9%)有异常表现;CT 检查80例,均显示肾损伤(100%)。保守治疗153例(74.6%);手术治疗52例,死亡5例(3.5%);超选择性肾动脉栓塞术29例。结论 B 超和 CT 检查是诊断肾损伤的有效方法。严格掌握手术时机是治疗闭合性肾损伤的关键。

Objective To evaluate the diagnosis and management of 205 cases of closed renal traumas.Methods 205 cases of closed renal traumas were reviewed retrospectively.Results There were 113 cases of renal contusion and 67 cases of renal laceration and 31 cases of renal multiple major laceration and 81 cases of renal injures complicated by other organ injuries.Hematuria was a main symptom.Aberrant findings were observered om ultrasonograohy in 165 out of 1999 (82.5) and on CTscan in 80 out of 80 (100%).153 cases (74.6%) were cured by con- servative treatment,52 cases by operation and 29 cases by selective renal artery embolization.Conclusion Ultrasonograohy and CT scan were ef- fective means for the diagnosis of closed renal traumas.The most important was to decide the treatment,open surgery or not.