148例闭合性肾损伤诊治体会

An experience with 148 cases of close renal trauma

目的 提高闭合性肾损伤的诊治效果。 方法 回顾分析１４８ 例闭合性肾损伤的诊治资料。 结果 血尿１３９ 例（９２ ．２％ ）；Ｂ超检查１４１ 例，其中１０９ 例（７７．３％ ） 有异常表现；ＣＴ 检查阳性５１／５７ 例（８９．７ ％） ；术中逆行造影８ 例，发现造影剂外溢２ 例。多发伤７３ 例。手术４３ 例（２９ ．１％ ），非手术１０５ 例（７０ ．９ ％） ，死亡６ 例（４．１％ ），治愈１４２ 例，７７ 例（５２－０％ ）随访１～３ 年，尿常规、肾功能正常。 结论 尿液检查和Ｂ超检查快速安全无损伤，ＣＴ 检查准确率高，并能同时了解其它脏器损伤的程度。如果损伤严重，需行外科处理，应及时手术探查。

Objective To present an experience with 148 cases of close renal trauma. Methods 148 cases of close renal trauma were retrospectively analysed. Results Hematuria occurred in 139 cases (92.2%).Aberrant findings were observed on ultrasonography in 109 out of 141 (77.3%) and on CT scan in 51 out of 57(89.7%).Retrograde pyelogram was performed during operation in 8 and aberrant finding was observed in 2.73 patients had injury of other organs.Open operation was undertaken in 43 (29.1%) and the others were treated nonoperatively.6(4.1%) died of shock and coexistent injury of other organs.The other 142 have been cared,77 of which have been followed up for 1～3 years with normal urine routine and renal function Conclusions Urine inspection and B ultrasonography were simple,instant reliable and harmless to the patient.The accurate diagnosis rate is high with CT scanning and is helpful in detecting any coexistent injuries.Surgical management is indicated in case of severe injury,prompt laparatomy should undertaken.