Tanaka M, Ozono S, Kimura S, Tanaka Y, Yoshida K, Hirao Y, Okajima E, Kaneko Y, Ueda Y, Kamada K
Department of Urology, Nara Medical University.
Hinyokika Kiyo. 1994 Nov;40(11):975-80.
A total of 70 patients with renal trauma were treated at the Department of Urology, Nara Medical University and Nara Prefectural Hospital, including Life-Saving Emergency center, from January 1982 to June 1993. They were between 3 and 79 years old (mean 30.0) and preponded to the younger generation. The main cause of injury was traffic accident in 46 cases (65.7%). According to the Classification of Renal Injury by the Japanese Association for the Surgery of Trauma in Japan, there were 31 cases (44.3%) of type I (subcapsular injury), 18 cases (25.7%) of type II (superficial injury), 15 cases (21.4%) of type III (deep injury), and 6 cases (8.6%) of type IV (pedicle injury). Surgical treatment was performed in 17 cases (24.2%). The major associated injuries were bone fracture in 32 cases (45.7%), lung injury in 17 cases (24.2%), and liver injury in 15 cases (21.4%). Furthermore, hydronephrosis and ureteral tumors were incidentally found in 4 and 1 patient during the course of treatment for renal trauma. Post-traumatic plasma renin activities (PRA) in types III and IV were significantly higher than those in types I and II. Hypertension developed in 1 case of types I and II and 4 cases of types III and IV. The mean level of PRA was significantly decreased 2 years after renal injury in both groups. We should bear in mind that renal trauma may be associated with other urological diseases such as hydronephrosis and urological malignancies, and post-traumatic PRA should be followed carefully.
1982年1月至1993年6月期间，奈良医科大学泌尿外科以及奈良县立医院（包括生命救助急诊中心）共收治了70例肾外伤患者。他们的年龄在3岁至79岁之间（平均30.0岁），以年轻人为主。受伤的主要原因是交通事故，共46例（65.7%）。根据日本创伤外科学会的肾损伤分类，Ⅰ型（包膜下损伤）31例（44.3%），Ⅱ型（浅表损伤）18例（25.7%），Ⅲ型（深部损伤）15例（21.4%），Ⅳ型（肾蒂损伤）6例（8.6%）。17例（24.2%）患者接受了手术治疗。主要的合并伤包括骨折32例（45.7%）、肺损伤17例（24.2%）、肝损伤15例（21.4%）。此外，在肾外伤治疗过程中，偶然发现4例肾积水和1例输尿管肿瘤。Ⅲ型和Ⅳ型创伤后血浆肾素活性（PRA）显著高于Ⅰ型和Ⅱ型。Ⅰ型和Ⅱ型中有1例发生高血压，Ⅲ型和Ⅳ型中有4例发生高血压。两组患者肾损伤2年后PRA平均水平均显著下降。我们应该记住，肾外伤可能与其他泌尿系统疾病如肾积水和泌尿系统恶性肿瘤有关，创伤后PRA应密切随访。
