Monstrey S J, vander Staak F H, vander Werken C, Debruyne F M, Severijnen R S, Goris R J
Department of General Surgery, University Hospital St. Radboud, Nijmegen, The Netherlands.
Z Kinderchir. 1988 Feb;43(1):31-4. doi: 10.1055/s-2008-1043408.
A retrospective study was carried out of 103 consecutive cases of urologic trauma in childhood. All data were compared with those of a study in 550 adult urological trauma patients to identify problems specific to the paediatric age group. Differences in anatomy and physiology make children more likely to sustain urological injury than adults, in cases of direct as well as indirect trauma. In childhood there is a significant higher incidence of preexisting renal disease. Assessment of urinary tract injuries in paediatric patients requires a higher index of suspicion and a broader indication for immediate radiographic evaluation. The therapeutic approach of urinary tract injuries in children should be identical to that in adults. The controversial renal lacerations can be managed medically (shallow renal lacerations) as well as surgically (major bleeding or extravasation, transsection of the kidney). Whenever possible, operation should be performed as an elective delayed procedure 2 to 6 days after injury. With this approach maximal renal salvation can be achieved without raising overall mortality and morbidity rates.
对103例连续性儿童泌尿外科创伤病例进行了回顾性研究。将所有数据与一项针对550例成年泌尿外科创伤患者的研究数据进行比较，以确定儿童年龄组特有的问题。解剖学和生理学上的差异使得儿童在遭受直接和间接创伤时比成人更容易发生泌尿系统损伤。儿童期存在肾脏疾病的发生率显著更高。评估儿科患者的尿路损伤需要更高的怀疑指数和更广泛的立即进行影像学评估的指征。儿童尿路损伤的治疗方法应与成人相同。有争议的肾裂伤可以通过保守治疗（表浅肾裂伤）以及手术治疗（严重出血或外渗、肾脏横断）。只要有可能，手术应在受伤后2至6天作为择期延迟手术进行。采用这种方法可以在不提高总体死亡率和发病率的情况下实现最大程度的肾脏挽救。
