School of Surgery, University of Western Australia, Crawley, WA, Australia; Department of Urology, Fremantle Hospital, Fremantle, WA, Australia.
BJU Int. 2014 Nov;114 Suppl 1:13-21. doi: 10.1111/bju.12902.
To review the literature and make practical recommendations regarding the conservative management of renal trauma.
Relevant articles and guidelines published between 1980 and 2014 were reviewed. Graded recommendations were constructed by a multi-disciplinary panel consisting of urologists, radiologists, and infectious disease physicians. These recommendations underwent formal review and debate at the Western Australian USANZ 2013 state conference, and were presented at the USANZ 2014 annual scientific meeting.
The literature on the conservative management of renal trauma is reviewed within the framework of the American Association for the Surgery of Trauma (AAST) kidney injury severity scale. Graded recommendations are made regarding several key topics including: imaging, inpatient management, antibiotics, return to activity, and follow-up. Grade IV injuries and intraoperative consults are examined separately in view of the difficulties these groups cause in making appropriate treatment decisions.
A practical clinical guideline is provided regarding the conservative management of renal trauma.
回顾文献并就肾损伤的保守治疗提出实用建议。
对 1980 年至 2014 年间发表的相关文章和指南进行了回顾。由泌尿科医生、放射科医生和传染病医生组成的多学科小组对推荐意见进行了分级。这些建议在 2013 年西澳大利亚 USANZ 州会议上进行了正式审查和辩论，并在美国泌尿外科学会 2014 年年会上进行了陈述。
本文在美国创伤外科学会（AAST）肾损伤严重程度分级的框架内对肾损伤的保守治疗文献进行了回顾。就包括影像学检查、住院管理、抗生素、恢复活动和随访等在内的几个关键主题提出了分级推荐意见。鉴于这些患者组在做出适当治疗决策方面存在困难，对 IV 级损伤和术中咨询进行了单独讨论。
提供了关于肾损伤保守治疗的实用临床指南。
