89例闭合性肾损伤的诊断和治疗.docVIP

89例闭合性肾损伤的诊断和治疗 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：89例闭合性肾损伤的诊断和治疗 1 1 一般资料 2 2 诊断与治疗 3 1 肾损伤类型 4 2 肾损伤诊断 4 3 肾损伤治疗 5 文2：闭合性肾损伤的诊断和治疗 6 1 临床资料 6 2 讨论 7 参考文摘引言： 10 原创性声明（模板） 11 文章致谢（模板） 12 正文 89例闭合性肾损伤的诊断和治疗 文1：89例闭合性肾损伤的诊断和治疗 Abstract： Objective To explore how to improve the level of diagnosis and treatment of closed renal The clinical data of 89 cases of closed renal injury treated between and were retrospectively routine test,Bultrasound and CT were applied synthetically to confirm the injury was divided to five degrees from I to of the degree included 19,23,27,14 and 6 cases in all of the 89 cases,12 cases were combined with other organ injury: one brain damage,one pulmonary contusion,seven celiac organ injuries and three bone to their condition,69 cases accepted coervative treatment,and the rest 20 cases accepted the surgery cases,fifteen patients accepted nephrectomy,and five patients kidney were other orga injuries all accepted corresponding All of the 89 cases recovered from their injury and no patient Bultrasound is the fit examination to the renal injury and especially the emergency is a kind of rapid and accurate examination for closed renal injury,which also plays an important role in the evaluation of the renal injury degree and the choice of the the injury kidney reasonably and positively is an effective treatment for the closed renal injury. Key words:kidney injury;diagnosis;treatment 在腹部损伤中，肾脏损伤占8%～10%，其中70%为钝性闭合伤[1]。1996年1月～2007年12月我院共收治闭合性肾损伤89例，现报告如下。 临床资料 1 一般资料 本组89例，男性72例，女性17例;年龄9～70岁，平均岁。左肾损伤58例，右肾31例。损伤原因：道路 交通 伤53例，坠落伤26例，钝物击伤8例，病理性肾损伤2例。合并其他脏器损伤12例，其中颅脑伤1例，肺挫伤1例，肝、脾、肠等腹腔脏器伤7例，肋骨、脊柱、骨盆、四肢骨折3例。肉眼血尿69例，镜下血尿18例，无血尿2例。患者均有伤侧腰部疼痛和叩击痛，部分严重者有肾区饱满触痛，并发休克15例，腹膜刺激症11例。 2 诊断与治疗 诊断及分类 根据患者外伤史和部位、伤后血尿和临床表现、以及尿常规检查结果可以初步确立闭合性肾损伤诊断，然后通过影像学检查了解肾损伤程度并进行分类。本组B超检查85例，发现有不同程度的肾损伤61例(%);CT检查82例，发现伤情78例(%)，其中肾挫伤21例、肾裂伤37例、肾碎裂伤18例、肾横断伤2例。同时发现肝破裂2例，脾破裂1例。按美国创伤外科协会(AAST)器官创伤严重程度定级标准(2001)分级：Ⅰ～Ⅴ级分别为19、23、27、14