论文部分内容阅读
目的:探讨急性闭合性肾损伤经后腹腔途径腹腔镜肾切除术的可行性。方法:回顾性分析3例急性闭合性肾损伤经后腹腔途径腹腔镜肾切除术患者的临床资料:男2例,女1例;1例体外碎石肾损伤,2例为外伤性肾损伤。超声提示肾破裂伴肾周高回声区,考虑为血肿。CT提示肾脏破裂伴肾周血肿,血肿局限于肾周筋膜内,1例造影剂外溢。3例均行腹腔镜肾切除术,结果:3例手术均顺利完成,手术时间85 min(60～120 min),出血量180 ml(100～300 m1)。术后病理检查提示肾脏破裂。结论:在腔镜技术熟练的前提下,选择性急性闭合性肾损伤且血肿局限于肾周筋膜内患者,在伤后1周内行腹腔镜肾切除可行。
Objective: To investigate the feasibility of laparoscopic nephrectomy in the treatment of acute closed renal injury by retroperitoneal approach. Methods: The clinical data of 3 patients with acutely closed renal injury who underwent laparoscopic nephrectomy via retroperitoneal approach were retrospectively analyzed. There were 2 males and 1 females, 1 case of gravel kidney injury in vitro and 2 cases of traumatic renal injury. Ultrasound prompt renal rupture with high perirenal echo area, considered as hematoma. CT showed renal rupture with perirenal hematoma, hematoma confined to the perinephric fascia, 1 case of contrast agent spilled. Laparoscopic nephrectomy was performed in 3 cases. All the 3 cases were successfully performed. The operation time was 85 min (60-120 min) and the amount of bleeding was 180 ml (100-300 m1). Postoperative pathological examination prompted renal rupture. Conclusions: Under the condition of proficient endoscopic technique, selective acute closed renal injury and limited hematoma in patients with perirenal fascia are feasible for laparoscopic nephrectomy within 1 week after injury.