Murphy Gregory P, Gaither Thomas W, Awad Mohannad A, Osterberg E Charles, Baradaran Nima, Copp Hillary L, Breyer Benjamin N
Department of Urology, University of California-San Francisco, San Francisco, CA, USA.
Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia.
Curr Urol Rep. 2017 Mar;18(3):23. doi: 10.1007/s11934-017-0665-z.
Review the current literature regarding the management of grade IV renal injuries in children.
Children are at increased risk for renal trauma compared to adults due to differences in anatomy. Newer grading systems have been proposed and are reviewed. Observation of most grade IV renal injuries is safe. Operative intervention is necessary for the unstable patient to control life-threatening bleeding with either angioembolization or open exploration. Symptomatic urinomas may require percutaneous drainage and/or endoscopic stent placement. Ureteropelvic junction (UPJ) disruption, seen more often in children, requires immediate surgical repair. Grade IV renal injuries in children are increasingly managed in a conservative manner.
回顾有关儿童IV级肾损伤治疗的当前文献。
由于解剖结构的差异，儿童相比成人发生肾创伤的风险更高。已提出并综述了更新的分级系统。大多数IV级肾损伤进行观察是安全的。对于不稳定的患者，需要进行手术干预以通过血管栓塞或开放探查控制危及生命的出血。有症状的尿囊肿可能需要经皮引流和/或内镜支架置入。肾盂输尿管连接处（UPJ）断裂在儿童中更常见，需要立即进行手术修复。儿童IV级肾损伤越来越多地采用保守方式处理。
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