Baeza-Herrera Carlos, Domínguez-Pérez Salomón T, González-Zarate Eduardo Francisco, García-Cabello Luis Manuel, Nájera-Garduño Heladio M, Gaspar-Ramírez Gabriel
Departamento de Cirugía General, Hospital Pediátrico Moctezuma.
Gac Med Mex. 2002 Jul-Aug;138(4):313-8.
The leading cause of death in children is accidents. Severe craniocerebral trauma and injuries to the heart or major vessels are mainly responsible for immediate death. This phenomenon is also reflected in the increasing number of pediatric admissions for renal trauma.
From 1990 to 2000, the charts of 132 patients with renal injuries secondary to blunt and penetrating trauma in childhood are reviewed.
A total of 88 were male patients and 126 sustained blunt trauma (motor accidents, falls, etc.). Gross and microscopic hematuria were the most important finding at the time of presentation, and correlated with severe renal injury, and both were present in 122 cases. Intravenous pyelography and CT scan were the most useful diagnosis tools. Only 27 patients were managed operatively, the majority because of associated intra-abdominal injury.
Intravenous pyelography remains the most cost-effective means of investigating renal injuries in a second-level hospital. Renal contusion and most laceration should be managed conservatively. Only few a renal transactions should be managed operatively.
儿童死亡的主要原因是意外事故。严重的颅脑创伤以及心脏或大血管损伤是导致即刻死亡的主要原因。这种现象也反映在因肾创伤而住院的儿童数量不断增加。
回顾了1990年至2000年期间132例儿童钝性和穿透性创伤继发肾损伤患者的病历。
共有88例男性患者，126例遭受钝性创伤（交通事故、跌倒等）。肉眼血尿和镜下血尿是就诊时最重要的发现，与严重肾损伤相关，122例患者二者均存在。静脉肾盂造影和CT扫描是最有用的诊断工具。仅27例患者接受了手术治疗，大多数是因为伴有腹部损伤。
静脉肾盂造影仍然是二级医院检查肾损伤最具成本效益的方法。肾挫伤和大多数撕裂伤应保守治疗。只有少数肾横断伤需要手术治疗。
