Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan.
Am J Surg. 2010 Feb;199(2):154-9. doi: 10.1016/j.amjsurg.2008.12.023.
Angioembolization is an effective adjunct in the management of high-grade renal injuries not surgically treated. However, in some cases, the bleeding may stop spontaneously, without the need for embolization. The aim of this study was to define the characteristics of patients who need angioembolization for high-grade blunt renal injuries (BRIs).
Patients with BRIs between January 2004 and May 2008 were retrospectively reviewed. Patients with contrast extravasation on computed tomographic scans who then underwent angiography were enrolled. Demographics, injury severity scores, abbreviated injury scale scores, amounts of blood transfused, and need for angioembolization were analyzed.
Twenty-six patients were enrolled. Patients with discontinuity of Gerota's fascia and pararenal hematoma expansion in BRIs required angioembolization at a higher rate. Furthermore, these patients displayed higher injury severity scores and abbreviated injury scale scores. Five patients experienced complications.
In patients with BRIs, discontinuity of Gerota's fascia and pararenal hematoma expansion seemed to be associated with the need for angioembolization. Early angioembolization should be considered in patients with severe associated trauma with BRIs.
血管栓塞术是治疗未手术治疗的高级别肾损伤的有效辅助手段。然而，在某些情况下，出血可能会自行停止，无需栓塞。本研究旨在确定需要血管栓塞术治疗高级别钝性肾损伤（BRIs）的患者的特征。
回顾性分析 2004 年 1 月至 2008 年 5 月期间的 BRIs 患者。对 CT 扫描显示造影剂外渗的患者进行血管造影，纳入研究。分析患者的人口统计学数据、损伤严重程度评分、简明损伤评分、输血量和血管栓塞术的需求。
共纳入 26 例患者。BRIs 中肾筋膜连续性中断和肾周血肿扩大的患者需要血管栓塞术的比例更高。此外，这些患者的损伤严重程度评分和简明损伤评分更高。5 例患者出现并发症。
在 BRIs 患者中，肾筋膜连续性中断和肾周血肿扩大似乎与血管栓塞术的需求相关。对于严重合并创伤的 BRIs 患者，应早期考虑血管栓塞术。
