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目的探讨闭合性肾外伤合并腹腔内脏器损伤的急诊处理措施。方法对本院最近10年收治的36例闭合性肾外伤合并腹腔内脏器损伤的救治资料进行回顾性分析。结果保守治疗3例均痊愈。施行急诊剖腹探查手术33例,其中8例同期切开后腹膜探查患肾,包括肾切除6例,肾部分切除1例,肾修补1例;25例未同期切开后腹膜探查患肾,均无因肾损伤二期手术者。手术组治愈30例,死亡3例。结论闭合性肾外伤合并腹腔内脏器损伤以剖腹探查手术治疗为主,术前CT检查可以准确进行肾外伤的分级,结合术中病情变化决定是否同期探查肾损伤。
Objective To investigate the emergency treatment of closed renal injury with intra-abdominal organ injury. Methods The data of 36 cases of closed renal trauma combined with intra-abdominal organ injury treated in our hospital for the past 10 years were retrospectively analyzed. Results Conservative treatment in 3 cases were cured. Thirty-three patients undergoing emergency exploratory laparotomy were enrolled. Among them, 8 patients underwent peritoneal exploration after simultaneous resection, including 6 cases of nephrectomy, 1 case of partial nephrectomy and 1 case of kidney repair. No renal injury two surgery. The operation group cured 30 cases, 3 died. Conclusions Closed renal injury combined with intra-abdominal visceral injury is mainly exploited by laparotomy. Preoperative CT examination can accurately grade renal trauma and determine whether renal injury should be probed during the same period with the change of intraoperative conditions.