82例闭合性肾脏损伤诊治分析

Analysis of the Diagnosis and Treatment of 82 Cases with Closed Kidney Injury

目的探讨闭合性肾脏损伤诊断和治疗的方法。方法对收治的82例创伤性闭合性肾脏损伤的临床资料进行回顾分析。结果82例中出现血尿者69例(84.1%),合并休克者21例(25.6%),伴有其他部位损伤者45例(54.9%)。80例行CT检查明确损伤程度。非手术治疗63例(76.8%),手术18例(21.9%),其中肾切除10例,肾修补8例。死亡1例。结论中、重度闭合性肾脏损伤患者伤后应尽可能选择CT检查,明确肾脏损伤程度及是否合并其它脏器损伤。闭合性肾脏损伤治疗以非手术为主,治疗期间严密观察病情进展,如非手术治疗无效应及时行手术探查治疗。

Objective To discuss the diagnosis and treatment of closed kidney injury. Methods A retrospective analysis was made to the clinical data of 82 cases with closed kidney injury. Results Out of the 82 cases, 69 cases had hematuria （ 84.1% ）, 21 eases complicated with shock （25.6%） , 45 cases had injury in other parts of the body （54.9%）. CT scanning was made to determine the injury degree. 63 cases received nonsurgical treatment （76.8%）, in 18 cases receiving operation （21.9%）, 10 cases received nephrectomy, 8 cases received kidney repair and 1 patient died. Conclusion CT scanning should be made for patients with midrange and severe kidney injury so as to determine the injury degree and if there exists injury of other organs. Non - surgical treatment is more often adapted for closed kidney injury , but close observation should be made to the disease progress so as to decide if operation＇is needed.