B超、CT检查对闭合性肾外伤诊治的作用

Roles of B-ultrasonography、 CT Examination in Diagnosis and Treatment of Blunt Renal Trauma

目的：探讨Ｂ超、ＣＴ检查在闭合性肾外伤诊治中的作用。方法：闭合性肾外伤５３ 例中，行Ｂ超检查２２ 例，诊断阳性率为７７．２％ ，ＣＴ检查３１ 例，诊断阳性率１００％ 。结果：Ⅰ及Ⅱ类（Ｓａｒｇｅｎｔ 分类法） 肾损伤４１ 例中，手术探查３ 例（７．３％ ），损肾切除１ 例（２ ．４％） ；Ⅲ及Ⅳ类肾损伤１２ 例中，手术探查１１ 例（９１．７ ％） ，损肾切除９ 例（７５ ％） 。结论：Ｂ超检查可以早期筛选和动态观察肾外伤，ＣＴ检查可以直观地显示肾外伤的部位和程度及判断肾功能。并可以尽量避免探查肾脏，对于没有大的肾内血管损伤应尽量保存肾脏。

From March 1993 to June 1996,53 patients with Blunt renal trauma were admitted to our hospital. B-ultrasonography was performed in 22 patients and CT in 31 patients, and their accurate diagnosis rates were 77.2% and 100% respectively. Among 41 patients with type Ⅰ or Ⅱ trauma, 3 (73%) underwent operation, 1 (2.4%) was treated by nephrectomy. Among 12 patients with type Ⅲ or Ⅳ trauma, 11 (91.7%) underwent operation and 9 were treated by nephrectomy. In our opinions, B-Ultrasonography can be applied in screening in early stage, and observing renal trauma repeadedly. CT examination can show the site and degree of renal trauma directly and can be applied in the diagnosis of the function of renal. Checking-up the injured renal should be avoid as best we can during operation. The renal should be preserved without injuring the main vessels.