Piechaud T, Ferrière J M, Carles J, Grenier N, Le Guillou M
Service d'Urologie, Hôpital Pellegrin Tripode, Bordeaux.
Ann Urol (Paris). 1988;22(4):273-7.
The analysis of a series of 248 cases led to the following conclusions: intravenous pyelography, together with nephrotomography and ultrasonography represent, the pillars of emergency assessment; computed tomography, performed systematically since 1985, is the most appropriate examination for the precise assessment of the lesions in a functioning kidney; arteriography is still essential in cases of urographically silent kidneys. The choice of therapeutic approach essentially depends on the type of the lesion: severe parenchymal lesions (type III) (58 cases) and certain cases of type II trauma (25 cases) underwent a deferred emergency operation which was as conservative as possible; pedicle lesions (type IV) and serious haemorrhagic lesions required emergency surgery (11 cases); type I or type II lesions with moderate hematomas were usually treated by simple observation (145 cases); cases of trauma seen at the stage of sequelae (8 cases) sometimes required a surgical solution (arteriovenous fistula, segmental ischaemia of the parenchyma with hypertension, encysted urinoma).
对248例病例的分析得出以下结论：静脉肾盂造影、肾断层摄影和超声检查是急诊评估的支柱；自1985年以来系统进行的计算机断层扫描是精确评估功能肾病变的最合适检查；动脉造影在尿路造影无异常的肾脏病例中仍然必不可少。治疗方法的选择主要取决于病变类型：严重实质病变（III型）（58例）和某些II型创伤病例（25例）接受了尽可能保守的延期急诊手术；蒂部病变（IV型）和严重出血性病变需要急诊手术（11例）；伴有中度血肿的I型或II型病变通常采用单纯观察治疗（145例）；后遗症期出现的创伤病例（8例）有时需要手术解决（动静脉瘘、伴有高血压的实质节段性缺血、包裹性尿囊肿）。
