闭合性肾脏损伤129例诊治分析

The diagnosis and treatment of the close renal trauma （a report 129 cases）

目的探讨闭合性肾脏损伤的诊断与治疗效果。方法回顾性分析129例闭合性肾脏损伤患者的临床资料。结果腰痛或腹痛109例，血尿113例，合并其它损伤81例。B超检查129例，IVU检查37例显示异常者23例，CT102例。手术探查17例，非手术112例。118例获得随访3～56个月，尿常规、B超、IVU均正常。结论尿液常规、超声检查为首选、快速、安全、无创检查；CT确诊率高，有助于判断肾脏损伤程度、恢复程度以及是否合并其它组织脏器损伤。损伤严重或合并其它脏器损伤者应及时手术探查。

Objective To evaluate the diagnostic rate and treatment effect of close renal trauma. Methods The clinical data of 129 cases of close renal trauma were analyzed retrospectively. Results Lumbago or bellyache occurred in 109 cases,hematuria 113 cases, coexistent injuries of other organs 81 cases. 129 cases were examined by type B-uhrasonography, 102 cases by CT scan open operation on 17 cases and others were treated non-operatively. 118 cases have been followed up for 3 months to 56 months with normal urine routine and IVU. Conclusions Usually urine inspection and B-ultrasonography were simple,instant reliable and safe. The accurate diagnosis rate was higher with CT scanning,CT scan was helpful in detecting the degree of renal injury and any coexistent injuries, and to estimate the treatment effect. Laparotomy should undertaken for the case of severe injury or with coexistent injuries in time.