《肾损伤》ppt课件.ppt

Ultrasonography Easy Fast Noninvasive Well descript the parenchyma and hematoma of kidney Radiology IVU(intravenous urography, excretory urography) Function of separate sides Urinary extravasation Enhanced CT scan Abdominal CT scan is the most direct and effective means of staging renal injuries Clearly defines parenchymal lacerations and urinary extravasation First choice for diagnosis renal injuries Radiology Plain scanning period Venous phase Portal venous phase Arterial phase Excretory period Plain scanning period Venous phase Arterial phase Excretory period Arteriography Defines major arterial and parenchyma injuries Arterial thrombosis and avulsion of the renal pedicle are best diagnosis Invasive , choose carefully Radiology Others Retrograde urography : dangerous with infection, should not be chosen MRI: noninvasive, as an alternate choice Treatment Emergency measures Resuscitation Treatment of shock and hemorrhage Evaluation associated injuries Minor renal injuries from blunt trauma account for 85% of cases do not require operation Renal contusion Partial laceration *Non-operative treatment Bed rest for 2~4 weeks Watchful waiting : vital signs, blood, urine Hydration and nutrition Antibiotics for prevent infection Symptomatic therapy：analgesic, sedative, hemostasis Operation indications Penetrating injuries: (Penetrating abdominal injury require operation, renal exploration is only an extension of this procedure) Severe blunt injuries: Deep laceration Multiple laceration Renal pedicle injuries [ Persistent retroperitoneal bleeding , Severe urinary extravasation ] Operation indications During non-operation treatment : Anti-Shock ineffective, or shock occurance again Hematuria get more severe Mass of abdominal enlarged Hemoglobin and hematocrit keep decreasing Suspicious of Abdominal organ injury Types of kidney injury? The simplest and the best checks are? Non-operative treatment of kidney trauma?