NISS在肾损伤治疗方案选择及预后判断中的意义

Significance of New Injury Severity Score in renal injury treatment options and prognosis

目的：探讨新损伤严重度评分（NISS）在肾损伤治疗方案选择及预后判断中的意义。方法：采用NISS对186例肾损伤患者治疗方案的选择及转归进行回顾性分析及评估。结果：开放性损伤手术探查率高于闭合性损伤（P〈0．01），开放性损伤与闭合性损伤NISS差异无统计学意义（P〉0．05）；NISS评分与治疗方案有关，手术率及肾切除率随NISS增加而增加，各组间差异有统计学意义（均P〈0．05）；随损伤部位数增加，损伤程度加重，NISS值升高，死亡率也升高（P〈0．05）。结论：NISS总分〈15分的伤情一般较轻，经保守治疗多可痊愈；NISS总分在15～34分之间，损伤程度为中度，推荐积极手术抢救；NISS总分在35～49分多为重型复合伤，建议在纠正休克及改善全身情况的基础上选择手术治疗，总分≥50分者不建议手术。

Objective：To explore the significance of New Injury Severity Score （NISS） in renal injury treatment options and prognosis. Method： The treatment options and prognosis of 186 cases with renal injury were retrospec tively analyzed and evaluated by NISS. Result： The open injury operation rate was higher than the blunt renal trauma （P〈0.01） . NISS score was no significant difference between open injury and closed renal injury （P〉0.05） . NISS score and treatment scheme were closely related. With NISS score increased, operation rate and renal resec tion rate increased accordingly. There was a significant difference between groups （P〈0.05, P〈0.05） . With the injury site and injury severity increased, NISS levels and mortality increased accordingly （P〈0.05）. Conclusion：Firstly NISS scores 〈15, patients conditions are light and most of them can be cured after conservative treat ment. Secondly NISS scores are between 15 34 points, the damages are moderate, proactive operation rescue shoule be recommended. Thirdly NISS score are between 35 49 points, operation treatments can be chosen based on correction of shock and improvement of general condition. And lastly NISS scores≥50 no operations are rec ommended.