Burbridge B E, Groot G, Oleniuk F F, Taranger L A, Barrett P H
Department of Medical Imaging, Royal University Hospital, Saskatoon, SK.
Can Assoc Radiol J. 1991 Oct;42(5):326-8.
In a prospective study the authors correlated the degree of hematuria and of blunt abdominal trauma with the results of emergency excretory urography. Urograms were obtained for 37 patients who presented with blunt abdominal trauma, no gross hematuria and at least five erythrocytes per high-power field (hpf) on microscopic urinalysis. Microscopic hematuria was defined as an erythrocyte count of more than 5 and fewer than 50 per hpf. Major trauma was defined as shock (systolic blood pressure of less than 90 mm Hg), fracture of the lumbar spine, the pelvis or the lower ribs, ecchymosis in the flank or acute abdominal injury. Contusions and small subcapsular hematomas were defined as nonsignificant renal injuries; all other renal injuries were defined as significant. Of 17 patients with minor blunt abdominal trauma 14 had fewer than 50 erythrocytes per hpf; none of these had a significant renal injury, whereas 1 of the 3 with more than 50 erythrocytes per hpf did have a significant injury. Of 20 patients with major trauma 5 had a significant renal injury. The authors conclude that microscopic hematuria associated with blunt abdominal trauma but without shock or major nongenitourinary injury does not warrant routine excretory urography.
在一项前瞻性研究中，作者将血尿程度及腹部钝性创伤与急诊排泄性尿路造影结果进行了关联分析。对37例腹部钝性创伤患者进行了尿路造影检查，这些患者无肉眼血尿，且显微镜下尿液分析每高倍视野（hpf）至少有5个红细胞。显微镜下血尿定义为每hpf红细胞计数超过5个且少于50个。严重创伤定义为休克（收缩压低于90mmHg）、腰椎、骨盆或下肋骨骨折、侧腹瘀斑或急性腹部损伤。挫伤和小的包膜下血肿被定义为无明显肾损伤；所有其他肾损伤被定义为明显肾损伤。在17例轻度腹部钝性创伤患者中，14例每hpf红细胞少于50个；这些患者均无明显肾损伤，而每hpf红细胞超过50个的3例患者中有1例有明显损伤。在20例严重创伤患者中，5例有明显肾损伤。作者得出结论，与腹部钝性创伤相关但无休克或重大非泌尿生殖系统损伤的显微镜下血尿无需常规进行排泄性尿路造影。
