肾损伤的诊治体会（附216例报告）.pdfVIP

安徽医学 2008年第29卷第4期 419 肾 损 伤 的 诊 治 体 会 (附216例报告) 李超志 朱 跃 冯鹏程 [摘 要] 目的 总结肾损伤的诊治体会，提高肾损伤的诊治水平。方法 回顾分析216例肾损伤患者的临床资 料。血尿208例(96．8％)；B超检查212例，148例(69．8％)有异常表现；CT检查65例，阳性表现52例(80％)。保守治 疗183例，其中27例保守治疗中因肉眼血尿进行性加重，血压下降而进行手术探查，7例肾包膜下巨大血肿患者病情稳 定后采用B超引导下经皮穿刺置管引流术，手术治疗60例。结果 死亡4例(1．9％)，治愈212例(98．1％)。结论 B 超检查具有迅速、安全、无创、阳性率高等特点，可作为初步判断肾损伤程度的首选检查项目。cT检查则对肾损伤程度 作较准确的判断。肾包膜下巨大血肿患者采用B超引导下经皮穿刺置管引流术是较为理想的治疗方法。 [关键词] 肾损伤；诊断；治疗 Experiences of diagnosis and management for renal trauma：report 216 casts Li Chaozhi，Zhu Yue， Pengcheng Department of Urology．NO．105 Hospital ofP ，Hefei 230031 [Abstract] 0bjective To study and improve the diagnosis and therapy of renal trauma．Methods 216 cases of renal trauma were analyzed retrospectively．Hematuria OCCUlTed in 208 cases(96．8％)；positive findings were observed on uhrasonog— raphy in 148 out of212(69．8％)and on CT scan in 52 out of 65(80％)；183 cases were treated nonoperatively，in which，27 cases were treated with operation，because the hematuria was getting severe and the blood pressure was unstable．Percutaneous drainage of the hematoma was undeaaken to treat 7 patients with huge traumatic subeapsular renal hematona when the patients condition was stable．Open operation was undeaaken in 60 cases．Results Four(1．9％)patients died and 212 have been cared (98．1％)．Conclusion B—uhrasonography was instant，reliable，harmless and high diagnostic rate to the patient，which must be the first examination to the patient of renal trauma．The CT scanning could obtain exactly diagnoses of renal trauma．Patients with huge traumatic subeapsular renal hematoma could be treated through percutaneous drainage by B—uhrasongraphy．It is an i— deal method． [Key words] Kidney injurie