Smith S D, Gardner M J, Rowe M I
Department of Surgery, University of Pittsburgh School of Medicine, PA.
J Trauma. 1993 Dec;35(6):861-4. doi: 10.1097/00005373-199312000-00010.
The cases of seven children treated from 1980 through 1991 with blunt renal artery injuries were reviewed to determine (1) if computed tomography alone could eliminate the need for intravenous pyelography (IVP) or arteriography (ART); and (2) the causes of management delays. The diagnosis of arterial occlusion was suggested by the lack of renal contrast enhancement in six patients with CT scans and in two patients with IVP. In three patients ART was merely confirmatory. The diagnosis was suggested by IVP or CT scan within a mean of 4.7 hours of injury, but ART added an additional mean 2.3 hours to the diagnostic workup. There was an additional 3.9-hour average delay in the operating room before revascularization. Six patients underwent revascularization. Four had minimal function by postoperative renal scans. Renal artery occlusion is rapidly detected by contrast-enhanced CT scanning without IVP or ART. The time period from diagnosis to revascularization must be expedited to improve renal outcome.
回顾了1980年至1991年期间接受钝性肾动脉损伤治疗的7例儿童病例，以确定：（1）仅计算机断层扫描（CT）是否可无需静脉肾盂造影（IVP）或动脉造影（ART）；以及（2）治疗延迟的原因。6例CT扫描患者和2例IVP患者因肾对比增强缺乏提示动脉闭塞诊断。3例患者ART仅起确诊作用。损伤后平均4.7小时内IVP或CT扫描提示诊断，但ART使诊断检查平均增加2.3小时。血管重建术前手术室平均还有3.9小时延迟。6例患者接受血管重建术。4例术后肾脏扫描显示功能轻微。无需IVP或ART，通过对比增强CT扫描可快速检测肾动脉闭塞。必须加快从诊断到血管重建的时间段以改善肾脏预后。
