Tong Y C, Chun J S, Tsai H M, Yu C Y, Lin J S
Department of Urology, National Cheng Kung University, Medical College and Hospital, Tainan, Taiwan, Republic of China.
J Urol. 1992 Apr;147(4):984-6. doi: 10.1016/s0022-5347(17)37441-4.
One of the most demanding situations for a urologist is to decide which blunt renal trauma patients need immediate surgical exploration. Although computerized tomography can offer a lot of invaluable information, clear guidelines for selection of surgical versus conservative treatment are still lacking. A retrospective study of 15 blunt renal trauma cases showed that the hematoma size measured from computerized tomography using the method of summation planimetry bears a much closer correlation with the clinical outcome of the patient than does the degree of kidney parenchymal defect. Moreover, the average bleeding rate, calculated by dividing the size of the hematoma by the time elapsed from injury to scanning, gives a more accurate prediction for the need for immediate surgical treatment.
对泌尿外科医生来说，最具挑战性的情况之一是决定哪些钝性肾损伤患者需要立即进行手术探查。尽管计算机断层扫描能提供许多宝贵信息，但对于选择手术治疗还是保守治疗，仍缺乏明确的指导原则。一项对15例钝性肾损伤病例的回顾性研究表明，使用求和平面测量法从计算机断层扫描中测得的血肿大小与患者的临床结局的相关性，比肾实质缺损程度更为密切。此外，通过将血肿大小除以受伤至扫描的时间计算出的平均出血率，能更准确地预测是否需要立即进行手术治疗。
