闭合性肾损伤148例临床分析

Diagnosis and treatment of closed renal trauma in 148 cases

目的:总结148例闭合性肾损伤的诊断及治疗方法,提高闭合性肾损伤的诊治水平。方法:本组B超、静脉肾盂造影(IVU)、CT检查阳性发现率分别为73.6%、52.4%、100%。非手术治疗122例;手术探查16例,其中肾切除10例,肾修补6例;选择性肾动脉栓塞治疗10例。结果:死亡5例(死亡率3.4%);143例治愈(治愈率96.6%)。结论:B超检查便捷、无损伤,可作为闭合性肾损伤首选检查方法;CT检查是闭合性肾损伤准确诊断及选择治疗方法的重要依据,Ⅳ级以下闭合性肾损伤尽可能采用非手术治疗。

Objective： To investigate the experience of diagnosis and treatment of closed renal trauma in 148 cases. Method：The positive rate of renal injury detected by B-ultrasonography, IVU and CT were 73.6 %, 52.4 % and 100% respectively. 122 cases were managed conservatively and 16 cases were treated with operation; Nepbrectomy and neoplasty of kidney were carried out in 10 and 6 cases respectively. 10 cases were treated with embolization of renal vessels. Result： Five patients died of the injury（mortality rate：3.4 %） ; 131 cases have been cured （cure rate：96.6%）. Conclusion：B-ultrasonography which is simple, reliable and harmless to the patients, is the first choice in detecting renal trauma. CT scan can provide a major basis for the diagnosis and treatment of closed renal trauma. For closed renal trauma below grade IV, conservative treatment is the better option.