164例肾损伤的诊治体会

An experience with 164 cases of renal trauma

目的探讨。肾损伤的诊断与治疗。方法回顾性分析2000年7月-2007年10月164例外伤性。肾损伤患者的临床资料。其中闭合性损伤158例（96.3％），开放性损伤6例（3.7％），合并伤70例（42.7％）。B超检查76例，CT检查52例，IVU检查16例。非手术治疗126例（76.8％），手术治疗36例（22．0％），选择性肾动脉栓塞治疗2例（1．2％）。结果B超阳性率73，7％，CT阳性率100％，IVU阳性率50．0％。死亡8例（4．9％），治愈156例（95.1％），66例（40．2％）随访1-3年，尿常规和。肾功能检查均正常。结论B超和CT检查简单、安全、无痛苦。CT检查更准确，可同时了解其他脏器受伤情况。其治疗主要取决于。肾脏伤情，严格掌握手术治疗和非手术治疗指征是处理肾损伤的关键。

Aim To evaluate the diagnosis and therapy methods of renal injury, Methods 164 cases of renal injuries were reviewed and analyzed,of which 158 cases were close renal injury（96.3% ） ,6 cases open renal injury（ 3.7% ） and 70 cases combined other injury （42.7% ）, 76 cases were examined by B-ultrasonography,52 cases by CT and 16 cases by IVU. 126 cases were treated conservatively （76.8%） ,36 cases underwent operation（22.0% ） and 2 cases were treated with selected renal arteriographic embolism（ 1.2% ）. Results the diagnostic positive rate of B-ultrasonography, CT and IVU was 73.7%, 100% and 50. 0%, respectively. 8 patients died of shock and coexistant injuries of other organs（ 4.9% ）, the other 156 have been cared （95.1% ） ,66 of which have been followed up for 1 - 3 years with normal urine routine and renal function. Condusions B-ultrasonography and CT are simple,reliable and harmless to the patient. The diagnostic rate of CT scanning is high,which is also helpful in detecting any eoexistant injuries . The treatment of renal injury depends on the condition of renal injury, and the most important thing is to decide the treatment strategy, whether to perform surgery or not.