Lipsky H, Petritsch P, Schreyer H
Br J Urol. 1975;47(7):711-20. doi: 10.1111/j.1464-410x.1975.tb04047.x.
In a series of 223 patients with blunt renal injury, 40 patients underwent angiography. From this experience the following conclusions have been drawn: If a renal injury is suspected the IVP must be done as soon as possible. In most cases the diagnosis can be confirmed. Mild injuries should be managed conservatively and therefore need no angiography. In life endangering injury there is no time for angiography. The operation should be done preferably by a transperitoneal approach to allow good control of the renal pedicle. Patients with severe injuries should undergo angiography. If there is no function on the IVP, angiography should be done immediately to diagnose possible arterial thrombosis. In most cases angiography can be carried out some days after the trauma. This investigation provides an exact diagnosis and helps in deciding about further treatment. If a major part of the kidney has no blood supply, or there is a rupture with a large perirenal extravasation of urine, we recommend conservative surgery to avoid early and late complications. All operations should be done some days after the trauma. All patients with renal injuries, either operated or conservatively managed, should be carefully followed up. Angiography should be done in all cases of post-traumatic hypertension.
在一系列223例钝性肾损伤患者中，40例接受了血管造影。基于此经验得出以下结论：如果怀疑有肾损伤，必须尽快进行静脉肾盂造影（IVP）。在大多数情况下，诊断可以得到证实。轻度损伤应采用保守治疗，因此无需进行血管造影。对于危及生命的损伤，没有时间进行血管造影。手术最好采用经腹途径，以便能很好地控制肾蒂。严重损伤的患者应进行血管造影。如果IVP显示无功能，应立即进行血管造影以诊断可能的动脉血栓形成。在大多数情况下，血管造影可在创伤几天后进行。这项检查能提供准确的诊断，并有助于决定进一步的治疗方案。如果肾脏的大部分没有血液供应，或者存在破裂且肾周有大量尿液外渗，我们建议采用保守手术以避免早期和晚期并发症。所有手术都应在创伤几天后进行。所有肾损伤患者，无论接受手术治疗还是保守治疗，都应进行仔细的随访。所有创伤后高血压病例都应进行血管造影。
