闭合性肾损伤142例临床诊治分析

Analysis of Diagnosis and Treatment of Closed Renal Trauma in 142 Cases

目的:探讨闭合性肾损伤的诊断与治疗方法,以提高临床诊治水平。方法:对2007-01～2011-12收治的142例闭合性肾损伤患者的临床资料进行回顾性总结分析。本组B超检查127例(89.4%),静脉尿路造影(IVU)98例(69.0%),CT检查142例(100%)。保守治疗103例(72.5%),手术治疗39例(27.5%)。结果:本组平均住院时间(23.7±8.4)d。治愈133例(占93.7%),9例(6.3%)死于多器官损伤合并休克。106例(74.6%)随访2个月～4.6年,定期复查血压、尿常规、肾功能和IVU均正常。结论:B超检查快捷、无创,可作为首选的筛查诊断方法;CT检查是本病准确诊断与选择治疗方案的重要依据。大部分肾损伤可保守治疗,严重者需手术治疗。

Objective：To explore the diagnosis and treatment of closed renal trauma in order to enhance clinical level in diagnosis and treatment.Methods：The clinical data of 142 cases with closed renal trauma hospitalized in our hospital from January 2007 to December 2011 were retrospectively analyzed.127 cases（occupied 89.4%） were detected by B-ultrasonography,98 cases（69.0%） by IVU and 142 cases（100%） by CT.103 cases（72.5%） were managed conservatively and 39 cases（27.5%） were treated with operation.Results：The mean hospital stay was（23.7±8.4）days.133 cases had been cured（cured rate：93.7%）,9 cases（6.3%） died of multiple organ injury complicated with shock.During the follow-up（2 months to 4.6 years） of 106 cases,the blood pressure,urine routine examination,kidney function and IVU were normal.Conclusions：B-ultrasonography which is simple,reliable and harmless to the patients,is the first choice in screening closed renal trauma.CT screen can provide a major basis for the diagnosis and treatment of closed renal trauma.The majority of renal trauma may be conservative therapy,serious renal trauma required surgery.