摘要
目的探讨肾外伤的急诊处理措施及其诊疗经验。方法回顾性分析2013年1月-2017年3月武汉大学人民医院泌尿外科收治的57例肾外伤患者的病例资料,包括临床特点、急诊处理及治疗方法、转归。结果 57例肾外伤患者39例,女18例,年龄4~74岁,中位年龄43.1岁。根据美国创伤外科协会(AAST)制定的肾外伤分级标准:Ⅰ级28例,Ⅱ级12例,Ⅲ级10例,Ⅳ级5例,Ⅴ级2例。57例肾外伤患者中,均无死亡病例。保守治疗成功41例(71.9%),介入栓塞肾动脉治疗7例(12.3%),行肾修补术4例(7.0%),保肾失败而行肾切除手术3例(5.3%),另2例(3.5%)轻度肾损伤的患者因脾破裂行剖腹脾切除,肾损伤保守治疗成功。结论 (1)肾外伤急诊救治的首要任务是尽快明确损伤类型和分级,再根据患者的具体病情选择合适的治疗方案;(2)绝大部分肾外伤患者均可通过严密监测保守治疗或介入治疗获得较好的治疗效果,只有少数患者需要手术探查修补或肾切除。
Objective To investigate the emergency treatment measures of renal trauma and its experience in diagnosis and treatment. Methods Retrospective analyses of 57 cases of renal trauma patients admitted to urology in Renmin Hospital of Wuhan University from January 2013 to March 2017 were enrolled. Results There were 57 renal trauma patients, 39 males and 18 females, aged 4-74 years,the median age was 43. 1 years. 57 cases of renal trauma patients were classified according to the American Association for the Surgery of Trauma, 28 belonged to grade Ⅰ, 12 belonged to Ⅱ,10 belonged to grade III, 5 belonged to grade IV and 2 belonged to grade V. There were no deaths in 57 patients with renal trauma. Conservative treatment was successful in 41 cases(71.9%), interventional embolization of renal artery in 7 cases(12.3%), renal repair in 4 cases(7.0%), nephron sparing treatment is failed and finally renal resection in 3 cases(5. 3%), and 2 cases(3.5%) of patients with mild renal injury was treated by laparotomy splenectomy due to rapture of spleen, renal injury was treated by conservative treatment successfully. Conclusion( 1) The primary task of renal trauma emergency treatment is clear as soon as the damage type and classification, and then choose the appropriate treatment according to the patients specific condition;(2) Most of the renal trauma patients can through conservative treatment or intervention of closely monitoring the desired therapeutic effect, only a few patients need surgical exploration or repair kidney resection.
出处
《疑难病杂志》
CAS
2017年第11期1152-1155,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
肾外伤
急诊处理
治疗
Renal trauma
Emergency treatment
Treatment
