闭合性肾损伤的诊断与治疗(附138例报告)

Diagnosis and treatment of close renal injury(Report of 138 cases)

目的 探讨肾损伤的诊断与治疗 ,以提高保肾率。方法 通过对 138例闭合性肾损伤回顾分析 ,其中伴合并伤 4 2例占 30 .4 3 %。B超检查 97例 ,IVU检查 2 9例 ,CT检查 12例 ,非手术治疗 10 4例占 75.36% ,手术治疗 34例占 2 4 .64 %。结果 B超检出率为 83 .51% ,IVU检出率为 89.66% ,CT检出率为 10 0 %。非手术治愈 10 4例 ,手术治愈 31例 ,死亡 3例。结论 B超检查最便捷 ,可初步判断伤肾情况。CT检查可准确地诊断肾损伤程度 ,增强后可观察双肾功能状况。手术治疗应掌握探查肾脏的时机 ,尽早修复肾脏 ,以降低肾损伤切肾率 。

Objective To evaluate the diagnosis and therapy methods of renal injury so as to increase the opportunities for retaining Kidneys.Methods 138 cases of close renal injury were analyzed retrospectively,of which 42 cases were accompanied by combined injury(30.43%),97 cases were examined by B Ultrasonography,29 cases were examined by IVU and 12 cases by CT,104 cases were treated with nonsurgical methods and 34 cases by operation.Results As for this disease,83.51% of the patients could be found by B ultrasonography,89.66% by IVU,and 100% by CT.104 cases could be cured with nonsurgical methods,31 cases by operation and 3 patients died.Conclusions B Ultrasonography was a reliable and simple method for the primary evaluation of renal injury.However,CT was more rapid and accurate.Contrast CT showed renal function and indicated the effect of treatment.The reduction of removal chances depended on the efforts to improve patients'general states actively,accurate estimation of injury types,repair of the breakage timely.Conservative treatment is an important method.