肾损伤213例临床分析

Clinical Analysis of 213 Patients with Renal Injury

目的:探讨肾损伤的诊断和治疗方法。方法:报告肾损伤213例,其中闭合性损伤202例(94.8%),合并伤31例(14.6%);B超检查196例,CT检查189例,静脉尿路造影(IVU)检查14例;非手术治疗175例(82.2%),手术治疗38例(17.8%)。结果:B超阳性率87.8%,CT阳性率100%,IVU阳性率71.4%;208例患者治愈,死亡5例,均为多器官损伤并休克患者。结论:B超检查最便捷,可初步判断肾脏伤情;CT可较准确地诊断肾损伤程度,可同时掌握腹腔脏器损伤情况;保守治疗是主要的治疗方法,手术治疗应掌握探查肾脏的时机,是否切除伤肾应以挽救患者生命为前提。

Objective： To evaluate the diagnosis renal injury were reviewed. 202 cases were close renal and therapy methods of renal injury. Methods：213 cases of injury （94.8%） and 31 cases combined injury （14.6%）. 196 cases were examined by B-ultrasonography,189 cases by CT and 14 cases by IVU. 175 cases were treated by conservatively （82.2%）and 38 cases underwent operation （17.8%）.Results：The diagnostic positive rate of B- uhrasonography, CT and IVU was 87.8%, 100% and 71.4% respectively. 208 cases were cured and 5 cases died of shock and coexistant injury of other organs. Conclusion： B-uhrasonography is reliable and simple method for the primary evaluation of renal injury. However, CT scanning has been the most reliable in evaluating the extent of the renal trauma and to detect any coexistent injury to abdominal organs. Conservative treatment is an important method. The key point in management is to decide whether surgical exploration is needed.