Salako Abdulkadir Ayo, Adisa Adewale Oluseye, Eziyi Amogu K, Banjo Oluseyi O, Badmus Tajudeen A
Department of Surgery, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
J Emerg Trauma Shock. 2010 Oct;3(4):311-3. doi: 10.4103/0974-2700.70742.
In a developing country with limited healthcare resources, traumatic injuries and their management pose a significant challenge to healthcare delivery.
To highlight the challenges in the management of traumatic urologic injuries in patients in our setting.
Patients presenting with traumatic injuries to the urinary tract, between January 1996 and December 2005, in a University Teaching Hospital in Southwestern Nigeria were the subjects of this study.
Clinical records of patients who had such injuries were reviewed.
Ninety injuries occurred in 86 patients including 77 males and 9 females aged 14-68 years. Fourteen (15.5%) of the injuries involved the kidneys, urinary bladder was involved in 23 (25.6%) and the male urethra in 53 (58.9%) injuries. The mechanisms of injury were road traffic accidents in 52 (60.5%) patients, straddle injuries in 18 (20.9%), trauma to the back in 8 (9.3%), falls from a height in 6 (7.0%) and gunshot injuries in 2 (2.3%) patients. Associated injuries include pelvic fractures in 33 (38.4%) patients, limb bone fractures in 13 (14.1%), intestinal injuries in 12 (13.0%) and spinal injuries in 8 (8.7%) patients. In most patients, diagnosis was made based on clinical suspicion and minimal investigations such as abdominal ultrasound, urethrocystoscopy and/or urethrocystography. The outcome was good in most patients and mortality was recorded in only 2 (2.3%) patients who had concomitant spinal and burns injuries.
Prompt management instituted on clinical suspicion of injuries presents a good outcome in patients in a limited resource setting.
在一个医疗资源有限的发展中国家，创伤性损伤及其管理对医疗服务构成了重大挑战。
强调我们所在地区创伤性泌尿系统损伤患者管理中的挑战。
1996年1月至2005年12月期间，在尼日利亚西南部一家大学教学医院就诊的尿路创伤患者为该研究对象。
回顾了有此类损伤患者的临床记录。
86例患者发生了90处损伤，其中男性77例，女性9例，年龄在14 - 68岁之间。14处（15.5%）损伤累及肾脏，23处（25.6%）累及膀胱，53处（58.9%）累及男性尿道。损伤机制包括52例（60.5%）患者因道路交通事故受伤，18例（20.9%）因骑跨伤，8例（9.3%）因背部外伤，6例（7.0%）因高处坠落，2例（2.3%）因枪伤。相关损伤包括33例（38.4%）患者合并骨盆骨折，13例（14.1%）合并四肢骨折，12例（13.0%）合并肠道损伤，8例（8.7%）合并脊柱损伤。大多数患者的诊断基于临床怀疑以及诸如腹部超声、尿道膀胱镜检查和/或尿道膀胱造影等少量检查。大多数患者预后良好，仅2例（2.3%）合并脊柱和烧伤损伤的患者死亡。
在资源有限的环境中，基于临床怀疑及时进行管理的患者预后良好。
