闭合性肾损伤的诊断与治疗(附165例报告)

Diagnosis and treatment of closed renal trauma (report of 165 cases)

目的探讨闭合性肾损伤的诊断与治疗原则。方法对1986年8月至2003年12月收治的165例闭合性肾损伤病例的临床资料进行回顾性分析。结果行B超、CT、静脉尿路造影(IVU)检查分别为125例(75.8%)、68例(41.2%)、32例(19.4%)。保守治疗118例(71.5%);手术治疗47例(28.5%),其中保肾手术29例(61.7%),包括选择性肾动脉栓塞术7例(24.1%)。治愈162例(98.2%),死亡3例(1.8%)。结论B超和CT检查可迅速诊断并正确评估肾损伤程度。依据损伤程度,及时制定方案,合理保肾治疗是治疗闭合性肾损伤的关键,微创治疗是治疗闭合性肾损伤的趋势。

Objective To explore the basic principle of diagnosis and treatment of closed renal trauma. Methods Clinical data of 165 cases of closed renal trauma from Aug 1986 to Dec 2003 were collected and retrospectively analyzed. Results 125 cases (75.8%) were diagnosed by Ultrasonography, 68(41.2%) by CT and 32 (19.4%) by IVU. 118 cases (71.5%) received conservative treatment. 47 cases underwent open operation and 29 patients kidney were reserved. 7 cases received selected renal arteriographic embolization. 3 patients died of the injury. Conclusion Ultrasonography and CT might diagnose quickly and evaluate accurately the degree of the closed renal trauma; they were the important ways of diagnosis. According to the degree of the closed renal trauma, it's essential to plan a scheme in time, and perform reasonable conservative treatment. Minimally invasive treatment is the tendency in the treatment of closed renal trauma.