Hoffman J R, Simon R R, Smith M, Strom G, Baraff L J
West J Med. 1987 May;146(5):576-9.
The role of intravenous pyelography (IVP) in the evaluation of blunt abdominal trauma is controversial. Major renal injuries have occasionally been reported in the absence of hematuria, but the test is not always accurate, is expensive and has potential morbidity. By reviewing the charts of 150 consecutive patients seen in an emergency department who had IVP for blunt abdominal trauma, we evaluated the ability of clinical and laboratory findings to predict IVP findings, the incidence of abnormal findings on IVP and the number of times IVP affected patient management. Only one patient's management was found to be clearly affected by the results of the IVP. We feel, therefore, that IVP should be reserved in cases of blunt abdominal trauma for patients with gross hematuria and those with microscopic hematuria and suggestive clinical findings. The absence of hematuria should preclude the use of IVP unless there are other exceedingly strong clinical findings.
静脉肾盂造影（IVP）在钝性腹部创伤评估中的作用存在争议。在无血尿的情况下偶尔也会报告严重肾损伤，但该检查并不总是准确的，费用高昂且有潜在的发病率。通过回顾150例在急诊科因钝性腹部创伤接受IVP检查的连续患者的病历，我们评估了临床和实验室检查结果预测IVP检查结果的能力、IVP异常检查结果的发生率以及IVP影响患者治疗的次数。仅发现1例患者的治疗明显受IVP结果影响。因此，我们认为，对于钝性腹部创伤患者，IVP应仅用于肉眼血尿患者以及镜下血尿且有提示性临床检查结果的患者。若无血尿，则不应使用IVP，除非有其他极其强烈的临床检查结果。
