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肾动脉栓塞术(RAE)治疗肾外伤的概况:两大创伤中心数据对比。

Profile of renal artery embolization (RAE) for renal trauma: A comparison of data from two major trauma center.

机构信息

Injury Prevention Research Center, Shantou University Medical College, Shantou, Guangdong, P.R. China.

Department of Urology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China.

出版信息

Int Braz J Urol. 2020 Mar-Apr;46(2):194-202. doi: 10.1590/S1677-5538.IBJU.2019.0506.

DOI:10.1590/S1677-5538.IBJU.2019.0506
PMID:32022507
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7025829/
Abstract

OBJECTIVE

To evaluate usage of renal artery embolization (RAE) for renal injuries and discuss the indications for this treatment.

MATERIALS AND METHODS

A retrospective study was performed evaluating the electronic medical records of all patients with renal trauma admitted to two major comprehensive hospitals in Shantou city from January 2006 to December 2015.

RESULTS

There were 264 and 304 renal traumatic patients admitted to hospital A and B, respectively. LGRT was the reason for presentation in the majority of patients (522, 91.9%). A total of 534 (94.0%) patients were treated conservatively. RAE was performed in 9 patients from 2012 to 2015 at hospital A, including in 6 patients (6/9, 66.7%) with LGRT, and 3 patients (3/9, 33.3%) with HGRT. No patient underwent interventional therapy (RAE) at hospital B during the same period. No significant differences in the operative rate of hospital A were observed between the two time periods (2006-2011 and 2012-2015). The operative rate for LGRT between the two hospitals from 2006 to 2011 and 2012 to 2015 was not significantly different. Hospital A showed a significant decrease in the rate of conservative treatment for patients with LGRT. In the univariate and multivariate analyses, the AAST renal grade both were significantly associated with undergoing RAE.

CONCLUSIONS

LGRT was present in the majority of patients, and most cases of renal trauma could be treated with conservative treatment. RAE was well utilized for the treatment of renal trauma. However, some patients with LGRT were treated with unnecessary interventional therapy.

摘要

目的

评估肾动脉栓塞(RAE)在肾损伤中的应用,并探讨该治疗方法的适应证。

材料与方法

对 2006 年 1 月至 2015 年 12 月期间在汕头市两家大型综合医院就诊的所有肾外伤患者的电子病历进行回顾性研究。

结果

A 医院和 B 医院分别有 264 例和 304 例肾创伤患者入院。LGRT 是大多数患者(522 例,91.9%)就诊的原因。共有 534 例(94.0%)患者接受了保守治疗。A 医院 2012 年至 2015 年共对 9 例患者进行了 RAE 治疗,其中 6 例(6/9,66.7%)为 LGRT,3 例(3/9,33.3%)为 HGRT。同期 B 医院无患者接受介入治疗(RAE)。同期 A 医院手术率在两个时间段(2006-2011 年和 2012-2015 年)之间无显著差异。两所医院 2006 年至 2011 年和 2012 年至 2015 年 LGRT 的手术率无显著差异。A 医院 LGRT 患者保守治疗率显著下降。单因素和多因素分析均表明,AAST 肾损伤分级与 RAE 显著相关。

结论

LGRT 是大多数患者的主要表现,大多数肾外伤患者可采用保守治疗。RAE 是治疗肾外伤的有效方法,但部分 LGRT 患者接受了不必要的介入治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e28/7025829/c20294cd2a91/1677-6119-ibju-46-02-0194-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e28/7025829/66903a4cfece/1677-6119-ibju-46-02-0194-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e28/7025829/c20294cd2a91/1677-6119-ibju-46-02-0194-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e28/7025829/66903a4cfece/1677-6119-ibju-46-02-0194-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e28/7025829/c20294cd2a91/1677-6119-ibju-46-02-0194-gf02.jpg

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本文引用的文献

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2
Renal trauma: imaging evaluation and implications for clinical management.肾脏创伤:影像学评估及其对临床处理的影响。
Abdom Radiol (NY). 2016 Aug;41(8):1565-79. doi: 10.1007/s00261-016-0731-x.
3
The role of interventional radiology for pediatric blunt renal trauma.
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Ital J Pediatr. 2015 Oct 15;41:76. doi: 10.1186/s13052-015-0181-z.
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High Grade Blunt Renal Trauma: Predictors of Surgery and Long-Term Outcomes of Conservative Management. A Prospective Single Center Study.重度钝性肾损伤:手术预测因素及保守治疗的长期预后。一项前瞻性单中心研究。
J Urol. 2016 Jan;195(1):106-11. doi: 10.1016/j.juro.2015.07.100. Epub 2015 Aug 6.
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Urotrauma: AUA guideline.尿路创伤:AUA 指南。
J Urol. 2014 Aug;192(2):327-35. doi: 10.1016/j.juro.2014.05.004. Epub 2014 May 20.
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