University Hospitals Birmingham, United Kingdom.
Trauma Audit & Research Network, United Kingdom.
Injury. 2019 May;50(5):1053-1057. doi: 10.1016/j.injury.2019.02.016. Epub 2019 Feb 22.
Urethral injury in major trauma is infrequent, with complex problems of diagnosis and treatment. The aims of this study are to determine the incidence and epidemiological factors relating to urethral injury in major trauma, as well as determine if any additional prognostic factors are evident within this cohort of patients. A retrospective review of patients sustaining urethral injury following major trauma was made over a 6-year period, from 2010 to 2015. Quantitative analysis was made using the national trauma registry for England and Wales, the Trauma Audit and Research Network (TARN) database, identifying all patients with injury codes for urethral injury. 165 patients with urethral injuries were identified, over 90% were male, most commonly injured during road traffic accidents and with an associated overall mortality of 12%. Urethral injury in association with pelvic fracture occurred in 136 patients (82%), representing 0.6% of all pelvic fractures, and was associated with double the rate of mortality. Urethral injury was associated with unstable pelvic fractures (LC2, LC3, APC3, VS, CM) but not with a specific pelvic fracture type. This study confirms the rare incidence of this injury in major trauma at 1 per 2 million population per year.
尿道损伤在严重创伤中并不常见，但在诊断和治疗方面存在复杂的问题。本研究旨在确定严重创伤后尿道损伤的发生率和相关的流行病学因素，并确定该患者群体中是否存在任何其他预后因素。对 2010 年至 2015 年期间发生的严重创伤后尿道损伤的患者进行了 6 年的回顾性研究。使用英国国家创伤登记处和创伤审核与研究网络（TARN）数据库进行定量分析，确定所有有尿道损伤编码的患者。共确定了 165 例尿道损伤患者，其中 90%以上为男性，最常见于道路交通伤害，总死亡率为 12%。136 例（82%）患者发生与骨盆骨折相关的尿道损伤，占所有骨盆骨折的 0.6%，死亡率增加一倍。尿道损伤与不稳定骨盆骨折（LC2、LC3、APC3、VS、CM）相关，但与特定的骨盆骨折类型无关。本研究证实，严重创伤中这种损伤的罕见发生率为每年每 200 万人中有 1 例。
