小儿闭合性肾损伤的治疗(附75例分析)

Management of closed renal trauma in children (a report of 75 cases)

目的探讨小儿闭合性肾损伤的最佳治疗方案。方法回顾性分析75例小儿闭合性肾损伤临床资料。其中肾被膜下血肿29例,肾实质部分裂伤23例,肾实质完全断裂11例,肾实质碎裂7例,肾蒂伤2例,肾盂输尿管连接处断裂3例。合并其他脏器伤者16例。结果非手术治疗59例,手术治疗16例,切除伤肾11只。74例治愈,死亡1例。结论小儿肾损伤后应尽快判断出肾脏损伤的程度及出血情况,根据病情选择不同的治疗方案;绝大多数闭合性肾损伤可采用非手术治疗。

Objective To explore the management of renal trauma in children.Methods The clinical materials were respectively analyzed in 75 children with closed renal trauma.Among them,29 cases were with renal contrusion,23 cases with part laceration of the renal parenchyma,11 cases with complete laceration of the renal parenchyma,7 cases with shattered kidney,2 cases with renal pedicle injury,3 cases with ureteropelvic disruptions and 16 cases were complicated with other organ injuries.Results Fifty-nine cases were treated conservatively.16 cases underwent surgical exploration and 11 injured kindeys were removed.Seventy-four cases were cured and one was dead.Conclusion The degree of renal trauma and the bleeding must be determined as early as possible.The surgery should be determined by the results of conservative treatment.Most Children with renal trauma could be treated by nonoperation.