外伤性肾损伤合并脾破裂32例诊治体会

Clinical experience of diagnosis and treatment for traumatic renal injury and splenic rupture(reports of 32 cases)

目的:总结32例肾损伤并脾破裂的诊断与治疗。方法:对32例肾损伤并脾破裂临床资料进行分析。结果:32例肾损伤并脾破裂患者中,保守治疗2例,手术治疗30例(脾切除8例,肾修补+脾切除12例,肾切除+脾切除6例,肾部分切除+脾切除4例),均痊愈出院。结论:肾损伤合并脾破裂诊断主要依靠外伤史、临床表现、尿检、B超和CT。Ⅲ级以上肾损伤即可考虑手术探查,手术治疗要尽可能保留肾功能。

objective：To summarize the diagnosis and treatment of traumatic renal injury and splenic rupture. Methods：Analysis was made in the clinical data of 32 patients with traumatic renal injury and ＂splenic rupture. Results： Among those cases,2 received the non-surgical treatment, 30 received the surgical treatment （8 received 12 received renal neoplasty＋splenectomy,6 received nephrectomy＋splenectomy,4 received splenectomy, partial nephrectomy＋ splenectomy）, all healed and discharged. Conclusion：The diagnosis of traumatic renal injury and splenic rupture de- pends on the surgical trauma history, clinical manifestation, urine test, B ultrasonography and CT examination. Renal injury of grade m and upwards can consider exploratory operation. During the operation, efforts should be made to preserve the renal function.