Knudson M M, McAninch J W, Gomez R, Lee P, Stubbs H A
Department of Surgery, University of California, San Francisco.
Am J Surg. 1992 Nov;164(5):482-5; discussion 485-6. doi: 10.1016/s0002-9610(05)81185-7.
Among the 1,484 patients included in the Renal Trauma Project with evidence of blunt trauma and hematuria, 160 patients were found to have both hematuria and a significant intra-abdominal injury not related to the genitourinary system. The incidence of abdominal injury generally increased with the degree of hematuria, approaching 24% in patients with gross hematuria. For each category of degree of hematuria, patients with shock had a significantly higher incidence of abdominal injury (p < 0.05) than patients without shock. The incidence of abdominal injury in patients with microscopic hematuria and shock was 29%, and it was 65% for patients with both gross hematuria and shock. All patients with gross hematuria after blunt abdominal trauma and all patients with microscopic hematuria and a history of shock should be evaluated for both urologic and extra-renal abdominal injuries.
在肾创伤项目纳入的1484例有钝性创伤和血尿证据的患者中，发现160例患者既有血尿又有与泌尿生殖系统无关的严重腹腔内损伤。腹腔损伤的发生率一般随血尿程度的增加而升高，肉眼血尿患者的发生率接近24%。对于每一类血尿程度，休克患者的腹腔损伤发生率显著高于无休克患者（p<0.05）。镜下血尿合并休克患者的腹腔损伤发生率为29%，肉眼血尿合并休克患者的发生率为65%。所有钝性腹部创伤后出现肉眼血尿的患者以及所有有镜下血尿和休克史的患者均应评估是否存在泌尿系统和肾外腹部损伤。
