Guerriero W G
Urol Clin North Am. 1977 Feb;4(1):3-12.
Injury to the upper urinary tract from penetrating trauma frequently is associated with injury to other abdominal organs. Management of the renal injury requires knowledge of the effect of injury of these other organs on the renal repair. Frequently the associated injury may dictate a need for nephrectomy when a complicated procedure would be necessary for repair of the kidney, but one should always keep in mind the high incidence of acute renal failure found in penetrating abdominal injuries and make a maximum effort to converse renal parenchyma in these patients. If renal repair is attempted, watertight repair of the renal collecting system, adequate debridement of injured renal tissue, accurate assessment of the presence or absence of blast effect, meticulous hemostasis, and adequate drainage are imperative.
穿透性创伤所致的上尿路损伤常伴有其他腹部器官损伤。肾损伤的处理需要了解这些其他器官损伤对肾脏修复的影响。当肾脏修复需要进行复杂手术时，相关损伤常常表明需要行肾切除术，但应始终牢记穿透性腹部损伤中急性肾衰竭的高发生率，并尽最大努力保留这些患者的肾实质。如果尝试进行肾脏修复，肾集合系统的水密修复、对受损肾组织的充分清创、对有无爆震效应的准确评估、细致的止血以及充分的引流是必不可少的。
