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尿创伤指南 2020:AUA 指南。

Urotrauma Guideline 2020: AUA Guideline.

出版信息

J Urol. 2021 Jan;205(1):30-35. doi: 10.1097/JU.0000000000001408. Epub 2020 Oct 14.

Abstract

PURPOSE

The authors of this guideline reviewed the urologic trauma literature to guide clinicians in the appropriate methods of evaluation and management of genitourinary injuries.

MATERIALS AND METHODS

The Panel amended the Guideline in 2020 to reflect additional literature published through February 2020. When sufficient evidence existed, the Panel assigned the body of evidence a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, the Panel provided additional information as Clinical Principles and Expert Opinions (See table 1[Table: see text]).

RESULTS

The Panel updated a total of six existing statements on renal, ureteral, bladder, urethra, and genital trauma. Additionally, four new statements were added based on literature released since the 2017 amendment. Statement 5b was added based on new evidence for treatment of hemodynamically unstable patients with renal trauma. Statement 20b was added based on new literature for percutaneous or open suprapubic tube placement following pelvic fracture urethral injury. Statements 30a and 30b were also added to provide guidance on ultrasonography for blunt scrotal injuries suggestive of testicular rupture and for performing surgical exploration with repair or orchiectomy for penetrating scrotal injuries respectively.

CONCLUSIONS

These evidence-based updates to the AUA Guidelines further inform the treatment of urotrauma.

摘要

目的

本指南的作者回顾了泌尿外科学创伤文献,以指导临床医生正确评估和处理泌尿生殖系统损伤。

材料和方法

小组在 2020 年修订了指南,以反映截至 2020 年 2 月发表的更多文献。当有足够的证据时,小组将证据体的强度等级评定为 A(高)、B(中)或 C(低),以支持强、中或条件推荐。在缺乏足够证据的情况下,小组提供了更多的临床原则和专家意见(见表 1[表:见正文])。

结果

小组总共更新了六项关于肾、输尿管、膀胱、尿道和生殖器创伤的现有陈述。此外,根据 2017 年修正案以来发布的文献,还增加了四条新的陈述。陈述 5b 是根据治疗肾创伤伴血流动力学不稳定患者的新证据增加的。陈述 20b 是根据骨盆骨折后尿道损伤的经皮或开放耻骨上管放置的新文献增加的。陈述 30a 和 30b 也被添加,以分别为钝性阴囊损伤提示睾丸破裂的超声检查和穿透性阴囊损伤的手术探查和修复或睾丸切除术提供指导。

结论

这些基于证据的 AUA 指南更新进一步为泌尿生殖系统创伤的治疗提供了信息。

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