泌尿系损伤肾损伤ppt课件.pptVIP

Chapter64. Injury of the Urinary System;General Conception ;Section Ⅰ Renal Trauma ;The kidney well protected the renal parenchyma is fragile with existing pathology conditions are more readily ruptured from mild trauma NOTE: vertebral【医】椎骨的 viscera【标】 n.内容; 肠; parenchyma 【医】实质;薄壁组织 fragile【标】a. 易碎的, 脆的 vasculature 【解】脉管系统 hydronephrosis【医】肾积水 malignant【医】恶性的 oscillation【医】振动;Etiology ;Blunt trauma: is the most common Most is minor. Chiefly in man (20-40y) and boys. NOTE: Motor vehicle【医】机动运输工具 mishaps(不幸之事, 灾祸) ;The mechanism and the reasons of such injuries remain obscure. ;Intimal tear ------ thrombus formation ----- arterial occlusion -----renal ischemia In children, the ureteropelvic junction 1aceration is common NOTE:retroperitoneum【医】腹膜后腔 tensile【标】a. 可拉长的, 可伸长的; magnitude【标】数量, 等级 elastin【医】弹性蛋白;;Penetrating trauma More likely to result in severs damage. Associated abdominal visceral injuries 80% The extent of injury ( eg. blast effect of bullet) NOTE: vasculature 【解】脉管系统 sever【标】v. 切断, 分开 blast【医】爆炸；吹风；气喷 Hypovolemic shock【医】低血容量性休克;Classification:;Minor renal trauma: contusions superficial lacerations Sub-capsular hematoma rarely require surgical exploration. NOTE: contusion / bruising 挫伤; lacerations撕裂伤 cortex【医】皮质; exploration【医】探查[术] ;Major renal trauma: Deep corticomedullary lacerations Multiple lacerations Injuries to the main renal vascular surgical intervention are more likely. NOTE:Corticomedullary【医】皮髓质的 extravasation【标】n. 溢出, 溢出物; Perirenal【医】肾周的;----Moore EE, Shackford SR, Pachtes HL, et al; J Trauma 1989; 29:1664-1666;Late pathologic findings:;Clinical manifestation:;SHOCK shock or signs of a large loss of blood shock without the presence of hematuria or only mild hematuria;HEMATURIA Microscopic or gross Catheterization usually reveals hematuria. The degree of renal injury does not correspond to the degree of hematuria NOTE: catheterization【医】导管插入术 urography【医】尿路造影[术];PAIN One flank area or over the abdom