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钝性肾损伤:单机构6年回顾性研究

Blunt Renal Trauma: A 6-Year Retrospective Review in a Single Institution.

作者信息

Hogea Anda Catinca, Scarneciu Ioan, Moga Marius Alexandru, Grigorescu Simona, Bisoc Alina, Hogea Mircea Daniel, Manea Rosana Mihaela

机构信息

Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania.

出版信息

Medicina (Kaunas). 2025 Mar 28;61(4):621. doi: 10.3390/medicina61040621.

DOI:10.3390/medicina61040621
PMID:40282912
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12028736/
Abstract

: Renal trauma is a significant consequence of both blunt and penetrating injuries, with management strategies having continuously evolved over recent years. This management requires careful clinical evaluation to balance the need for operative or non-operative treatment. This is especially critical in the context of the increasing trend of non-operative management for stable renal injuries, largely due to advances in imaging, improved hemodynamic stabilization, and better outcomes with conservative approaches. The main objectives of this study were to evaluate the epidemiology of renal trauma, the mechanism of injury, and the outcomes of management strategies in blunt renal trauma and determine their influence on morbidity and mortality rates. : A retrospective review was conducted with patients diagnosed with renal trauma in the Emergency Clinical County Hospital in Brasov, Romania from 1.01.2018 to 31.12.2023. Data were collected from medical records. : A total of 89 patients with blunt renal trauma were identified. The most frequent renal injuries, according to AAST classification, were grade 2 in 34.83% of the patients and grade 1 in 26.97% of the patients. Most of them, 84.27%, were managed conservatively. The overall mortality rate was 12.36%. : This review highlights the importance of personalized management strategies for renal trauma, especially emphasizing conservative treatment for hemodynamically stable patients. Our findings contribute to understanding renal trauma outcomes and should improve future clinical practices and guidelines in renal trauma management. Further studies should explore long-term outcomes and optimize treatment protocols.

摘要

肾外伤是钝性和穿透性损伤的一个重要后果,近年来其治疗策略不断演变。这种治疗需要仔细的临床评估,以平衡手术治疗或非手术治疗的需求。在稳定肾损伤非手术治疗趋势增加的背景下,这一点尤为关键,这主要归因于影像学的进步、血流动力学稳定的改善以及保守治疗方法带来的更好结果。本研究的主要目的是评估肾外伤的流行病学、损伤机制以及钝性肾外伤治疗策略的结果,并确定它们对发病率和死亡率的影响。

对2018年1月1日至2023年12月31日在罗马尼亚布拉索夫县急诊临床医院诊断为肾外伤的患者进行了回顾性研究。数据从病历中收集。

共确定了89例钝性肾外伤患者。根据美国创伤外科学会(AAST)分类,最常见的肾损伤是2级,占患者的34.83%,1级占患者的26.97%。其中大多数,即84.27%,采用保守治疗。总死亡率为12.36%。

本综述强调了肾外伤个性化治疗策略的重要性,尤其强调对血流动力学稳定患者的保守治疗。我们的研究结果有助于理解肾外伤的结果,并应改善未来肾外伤治疗的临床实践和指南。进一步的研究应探索长期结果并优化治疗方案。

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Operative and nonoperative management for renal trauma: comparison of outcomes. A systematic review and meta-analysis.肾创伤的手术与非手术治疗:结局比较。一项系统评价与荟萃分析。
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Post-traumatic acute kidney injury: a cross-sectional study of trauma patients.创伤后急性肾损伤:一项对创伤患者的横断面研究。
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