团体运动中肾和睾丸损伤发生率:10年14763例创伤患者回顾性分析

Incidence of renal and testis injuries in team sports: retrospective analysis of 14 763 cases of wound during ten years

目的:已有睾丸或者肾脏损伤患者是否适合参与团体运动存在争议,为此研究肾脏和睾丸在团体运动中损伤的发生率,为患者选择是否参与团体运动提供理论依据。方法:对运动引起的肾脏或睾丸损伤的患者进行回顾性研究。对损伤程度、后果及损伤的外部原因和患者人数进行统计,将没有影像学证据或客观依据(尸检或手术)的患者排除在外。结果:1992-07/2002-10收治创伤患者14763例中,450例在门诊诊断为肾脏或睾丸损伤,但只有209例患者符合损伤诊断标准。其中肾脏损伤193例(92.3%),睾丸损伤16例(7.7%)。娱乐活动或团体运动损伤共计113例54.1%),其中只有10例4.8%)(肾脏损伤6例,睾丸((损伤4例)为团体运动引起。在研究期间内团体运动损伤占所有创伤3.4%。团体运动损伤中没有只有单侧肾脏或睾丸的患者,只有1例患者患有先天性输尿管肾盂连接处梗阻,3例合并其他脏器损伤(脾脏2例,骨骼肌肉系统1例),4例睾丸损伤的患者都行了外科探查术,急诊修补肾损伤例,对先天性输尿管肾盂连接处梗阻患者行延迟肾盂成1形术。没有器官功能丧失,所有患者恢复满意。结论:团体运动发生肾脏和睾丸损伤和其他外部原因造成损伤相比发生率极低,大多数患者最终没有丧失受损器官,建议只有一侧睾丸或肾脏患者避免参与团体运动是不必要的。

AIM:There are arguments about whether the patients with renal and testis injury should take part in team sports. The aim of this paper is to study the injured incidence of renal and testis in team sports so as to provide theoretical basis for the studies on whether patients take part in team sports or not. METHODS:The patients with renal or testis injuries induced by sports were studied retrospectively.Severity,outcome,external cause of injury and quantity of patients were evaluated. Patients without radiographic or physical(postmortem or surgical) evidence of injury were excluded. RESULTS:Of 14 763 patients with wound from July 1992 to October 2002, 450 in the out patient clinic were diagnosed as having renal or testis injury,but only 209 patients met the diagnostic criteria of injury.There were 193 cases of renal injury(92.3%)and 16 cases of testis injury(7.7%).A total of 113 patients were injured in recreational activities or in team sports(4.8%),and only 10 cases(4.8%)(six cases of renal injury, four cases of testis injury) were induced by team sports.Overall team sports injuries in the trauma registry for the study period was 3.4%.No team sports injured patient had a solitary testis or kidney and only one patient had congenital ureteropelvic junction obstruction.There were 3 cases of associated injuries(two cases of spleen, one cases of skeletal).Surgical exploration was performed in all 4 testis injury cases, acute repair of renal injury was done,and the patient with congenital ureteropelvic junction obstruction received delay nephrapyeloplast.There was no functional incapacitation of organs,and all the patients recovered. CONCLUSION:The incidence of renal and testis injuries in team sports is much lower than other external causes of injury.Most patients ultimately do not lose their injured organs.The suggestion of avoiding from participance in team sports may not be necessary for patients with a solitary kidney or testis.