Govindarajan Krishna Kumar, Utagi Mallikarjun, Naredi Bikash Kumar, Jindal Bibekanand, Sambandan Kumaravel, Subramaniam Deepakbharathi
Jawaharlal Institute of Postgraduate Medical Education & Research, Departments of Pediatric Surgery & Radiology, Dhanvantri Nagar, Pondicherry 605006, India.
J Bras Nefrol. 2019 Apr-Jun;41(2):172-175. doi: 10.1590/2175-8239-JBN-2018-0186. Epub 2019 Jan 10.
The aim of this study was to analyze the presentation and management of major grade renal trauma in children.
A retrospective study was performed including data collected from the patients who were admitted in Pediatric surgery with major grade renal injury (grade 3 and more) from January 2015 to August 2018. Demography, clinical parameters, management, duration of hospital stay and final outcome were noted.
Out of 13 children (9 males and 4 females), with age range 2-12 years (mean of 8 years), reported self-fall was the commonest mode of injury followed by road traffic accident. The majority (10/13, 75%) had a right renal injury. Eight children had a grade IV injury, one had a grade V injury, and four children had grade III injury. Duration of hospital stay varied from 3 to 28 (mean of 11.7) days. Three children required blood transfusion. One child required image guided aspiration twice and two required pigtail insertion for perinephric collection. All the 13 children improved without readmission or need for any other surgical intervention.
Children with major grade renal trauma due to blunt injury can be successfully managed without surgical intervention and minimal intervention may only be needed in select situations.
本研究的目的是分析儿童重度肾外伤的表现及治疗方法。
进行一项回顾性研究，收集2015年1月至2018年8月因重度肾损伤（3级及以上）入住小儿外科的患者的数据。记录人口统计学、临床参数、治疗方法、住院时间及最终结果。
13名儿童（9名男性，4名女性），年龄范围为2至12岁（平均8岁），报告称最常见的受伤方式是自行摔倒，其次是道路交通事故。大多数（10/13，75%）为右侧肾损伤。8名儿童为IV级损伤，1名儿童为V级损伤，4名儿童为III级损伤。住院时间从3天到28天不等（平均11.7天）。3名儿童需要输血。1名儿童需要在影像引导下进行两次穿刺抽吸，2名儿童需要置入猪尾导管引流肾周积液。所有13名儿童病情均好转，无需再次入院或进行任何其他手术干预。
钝性损伤导致重度肾外伤的儿童无需手术干预即可成功治疗，仅在特定情况下可能需要极少的干预措施。
