58例闭合性肾损伤的诊治分析

摘要

Objective To analyze the diagnosis and treatment of renal trauma and discuss the therapeutic effects.Methods The clinical data of 58 patients with closed renal injury treated in our hospital were retrospec-tively analyzed .Of all the 58 patients ,there were 51 patients with hematuria and 12 patients with mass;31 patients received B-ultrasonic examination ,of whom 12 patients were diagnosed;CT examination was used in 36 patients and all of them were diagnosed;IVP examination was used in 12 patients and 7 of them were abnormal;39 patients were treated conservatively while 19 patients underwent operation .Results Two patients died of brain injury and hemor-rhagic shock owing to rupture of liver and spleen;one patient was cured because of urine leakage resulting from renal tissue residues after nephrectomy;56 patients were cured in total .Conclusion Based on CT examination ,accurate judgements can be made and obtained on the degree of injury ,especially on the extent of the damage .Strictly maste-ring the indications of operation or conservative treatment is the key to the treatment of renal injury .%目的总结肾损伤的诊治资料，探讨肾损伤的诊治效果。方法回顾性分析58例闭合性肾损伤临床资料。血尿51例，肿块12例，B超检查31例，21例确诊； CT检查36例全部确诊；静脉肾盂造影（ IVP）检查12例，7例有异常表现。非手术治疗39例，手术治疗19例。结果2例分别因合并肝脾破裂致失血性休克和颅脑损伤死亡。1例肾切除术后因肾组织残留、尿漏，再次手术治愈。共治愈56例。结论CT对损伤程度能作出准确的判断，特别是损伤的程度，可获得准确判断，应作为首选。严格掌握手术和非手术治疗的指征是处理肾损伤的关键。