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患儿,男,9岁,学生。2天前从7m高处摔下,左腰背部撞在硬物上,即述腰痛厉害,5小时后解血尿1次,当地治疗无好转入我院。检查T38.5℃,P132次/分,R34次/分,BP14/10kPa,神清合作,面色苍白,强迫体位,腹部左侧有压痛,反跳痛,肌紧张,肝脾未扪及,腹部无移浊,肝浊音界存在,肠鸣音减弱,左腰部有3cm~2之皮肤擦伤区,左腰肋角饱满,软组织肿胀,触痛。Hb60g/L;尿常规:RBC++,脓细胞少许;A超在左腰部探及2cm液平。诊断为肾破裂尿外渗。住院次日即行左肾探查术,术中见:腰部肌肉等组织水肿,肾周围积血积液,分开脂肪囊
Children, male, 9 years old, student. 2 days ago fell from a height of 7m, the left lower back hit the hard object, which described the severe back pain, hematuria after 5 hours 1 times, no local treatment into my hospital. Check T38.5 ℃, P132 beats / min, R34 beats / min, BP14 / 10kPa, Shenqing cooperation, pale, forced position, left abdomen with tenderness, rebound tenderness, muscle tension, palpable liver and spleen, abdomen No turbidity, voiced sound sector exists, bowel sounds weakened, the left waist with 3cm ~ 2 skin abrasion area, full of left lumbar ribs, soft tissue swelling, tenderness. Hb60g / L; urine routine: RBC ++, a little pus; A ultra-low in the left waist and 2cm level. Diagnosis of renal rupture of urine extravasation. On the next day that line left kidney exploration surgery, intraoperative see: lumbar muscles and other tissue edema, hydronephrosis around the kidney, separate fat capsule