|本期目录/Table of Contents|

[1]祖 峰,陈 明,郭霞庆.闭合性肾损伤84例诊治分析[J].医学研究与战创伤救治(原医学研究生学报),2009,11(03):224-226.
　ZU Feng,CHEN Ming,GUO Xiao-qing.Analysis on diagnostic and treatment of 84 cases of closed renal trauma[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(03):224-226.
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闭合性肾损伤84例诊治分析()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第11卷
期数:
2009年03期
页码:
224-226
栏目:
出版日期:
2009-05-20

文章信息/Info

Title:
Analysis on diagnostic and treatment of 84 cases of closed renal trauma
文章编号:
1672-271X(2009)03-0224-03
作者:
祖 峰1; 陈 明2; 郭霞庆2
1.江苏省阜宁县人民医院泌尿外科，江苏阜宁 224400；2.南京市鼓楼医院，江苏南京 210008
Author(s):
ZU Feng1; CHEN Ming2; GUO Xiao-qing2
1．Department of urinary surgery,Funing Country People’s Hospital, Yancheng 224000,Jiangsu,China；2．Nanjing Drum Tower Hospital，Nanjing 210008,China
关键词:
肾损伤; 闭合性; 治疗
Keywords:
Trauma;  Renal injury;  Treatment
分类号:
R691.6
DOI:
-
文献标志码:
A
摘要:
目的 探讨闭合性肾损伤合理的诊断与治疗方案。方法 84例经CT证实为闭合性肾损伤的病例，均无其他脏器严重损伤，采用美国创伤外科学会(AAST)分级标准，回顾性分 析84例闭合性肾损伤的诊断、治疗与预后。结果 84例CT诊断符合率100%，Ⅰ级69例，Ⅱ级8例，Ⅲ级5例，Ⅳ级2例，无Ⅴ级损伤病例。非手术治疗78例(92.9%)，成功率94.9% (74/78)，9例需手术治疗(10.7%)，其中4例为延迟肾切除术，5例急诊手术，伤肾切除7例(8.3%)，2例修补术，介入治疗1例(1.2%)，无死亡病例。早期继发出血和感染4例行延迟肾 切除术，2例迟发性再出血保守治疗成功，随访中肾萎缩和肾积水各1例，无高血压。结论 闭合性肾损伤以CT为首选确诊方法；轻度损伤首选非手术治疗，严重肾实质损伤和非手术 治疗无效时应及早手术治疗。
Abstract:
Objective To evaluate the optimal evaluation and treatment of closed renal trauma.Methods The diagnostic and treatment of 84 cases of closed renal trauma were retrospectively analyzed. All cases were performed by Computer Tomography (CT) scan to make a definite diagnosis of renal injury. The Committee on Organ Injury Scaling of the American Association for the Surgery of Trauma (AAST) classification was preformed in all 84 cases. Results All cases were diagnosed by CT scan. There were 69 cases of grade Ⅰ, 8 cases of grade Ⅱ, 5 cases of grade Ⅲ and 2 cases of grade Ⅳ. Non-operative treatment were performed on 78 cases (92.9%), and success rate was 94.9% (74/78). The other 9 cases were treated with operation, including 7 cases with nephrectomy, 2 cases with renorrhaphy. Among them, delayed operation was performed on 4 cases and emergency operation on 5 cases. Arteriography with selective renal embolization was performed on 1 case (grade 2). Complications include infection and delayed bleeding on 6 cases, and result in nephrectomy in 4 cases, 1 cases of nephrarctia and hydronephrosis repectively. Conclusion CT is the optimal evaluation for closed renal injury. Surgical management is indicated in case of severe injury and cases in which non-operative treatment was ineffective, while non-operative treatment is the first choice of mild injury.

参考文献/References:

[1] 朱先存，左鲁生，王振德，等.经直肠彩超检查在前列腺脓肿中的诊断价值[J].实用全科医学，2004，2(1):18-19.
[2] 王伟，谭杰琳.前列腺脓肿的诊断与治疗(附3例报告及文献复习)[J]. 医师进修杂志，2003，26(9) :12-13.
[3] 董林森，刘恩清，严泉剑，等.腔内超声诊断并穿刺治疗前列腺脓肿的临床研究[J].中国超声诊断杂志，2001，2(8):36-38.
[4] 汪石盘，朝淑娟，李秀山，等.会阴部超声引导下经直肠穿刺治疗前列腺脓肿[J]. 中国超声诊断杂志，2005，6(10):753-755.

相似文献/References:

[1]姚 宁,姜朝晖,方晓明,等.闭合单纯性肠系膜撕裂伤的诊治分析[J].医学研究与战创伤救治(原医学研究生学报),2009,11(02):149.

备注/Memo

备注/Memo:
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更新日期/Last Update: 2013-11-20