闭合性肾损伤76例临床诊疗分析

Diagnosis of closed kidney injury in 76 cases

目的：探讨闭合性肾损伤的诊断与治疗原则。方法：对1996年1月～2007年9月收治的76例闭合性肾损伤患者的临床资料进行回顾性分析。行B超、CT、静注尿路造影（IVU）检查者分别为65例（85．52％）、58例（76．31％）、18例（23．68％）。保守治疗64例（84．21％），手术治疗12例（15．79％），其中保肾手术7例。结果：治愈74例，死亡2例，其中1例合并骨盆骨折失血过多死亡，1例因合并颅脑损伤死亡。结论：B超和CT检查可迅速诊断并正确评估肾脏损伤程度。合理保肾是闭合性肾损伤的有效治疗方法。

Objective： To study the diagnosis and principle of treatment of closed renal injury. Methods： Clinical data of 76 patients with closed renal injury from January 1996 to September 2007 were studied retrospectively. Ultrasound, CT and intravenous urography （IVU） were used for 65 cases （85.52%）, 58 cases （76. 31% ） and 18 cases （23.68%） respectively. 64 cases （84.21%） underwent conservative treatment ; 12 cases （15.79%） underwent surgery, of which seven were treated by kidney sparing surgery. Results： Seventyfour cases were cured and 2 cases died, of which one died of excessive blood lose because of pelvic fractures, another died of coexisted head injury. Conclusion： Ultrasound and CT examination can diagnose renal injury promptly and evaluate correctly the extent of injury. Reasonable kidney sparing surgery is an effective treatment for closed renal injury.