闭合性肾外伤合并腹腔内脏器损伤的急诊救治(附36例报告)

Emergency management for blunt renal trauma complicated with abdominal injury.

目的探讨闭合性肾外伤合并腹腔内脏器损伤的急诊处理措施。方法对本院最近10年收治的36例闭合性肾外伤合并腹腔内脏器损伤的救治资料进行回顾性分析。结果保守治疗3例均痊愈。施行急诊剖腹探查手术33例,其中8例同期切开后腹膜探查患肾,包括肾切除6例,肾部分切除1例,肾修补1例;25例未同期切开后腹膜探查患肾,均无因肾损伤二期手术者。手术组治愈30例,死亡3例。结论闭合性肾外伤合并腹腔内脏器损伤以剖腹探查手术治疗为主,术前CT检查可以准确进行肾外伤的分级,结合术中病情变化决定是否同期探查肾损伤。

Objectives To evaluate the emergency management for blunt renal trauma complicated with abdominal injury. Methods The clinical data of 36 cases with blunt renal trauma complicated with abdominal injury from May 1995 to March 2005 were studied retrospectively. Results Three cases recovered after non - operative management. The other 33 cases were done laparotomy, and renal explorations were performed in 8 of them. Thirty cases recovered after operation and three died postoperatively. Conclusions Laparotomy is the main choice for the patients of blunt renal trauma complicated with abdominal injury. Whether the renal exploration should be done or not relies on preoperative CT and the patients condition during operation.