Bahloul A, Krid M, Trifa M, Mosbah A T, Mhiri M N
Service d'Urologie, C.H.U Habib Bourguiba, Sfax, Tunisie.
Ann Urol (Paris). 1997;31(5):253-8.
The authors report a retrospective study of 34 cases of blunt renal trauma affecting a pathological kidney out of a total of 156 cases of renal trauma. The patients were between the ages of 3 and 60 years, with a male predominance (sex-ratio: 2.4). The predominant cause of trauma was a household accident, in 15 cases (44%). The clinical features were dominated by haematuria and pain. The underlying renal disease was dominated by renal stones (15 cases, 44%) and ureteropelvic junction (UPJ) abnormality (10 cases, 29%). Twelve patients with benign trauma and minimal underlying renal disease were treated conservatively. Surgery was indicated in the remaining 22 patients, but only 20 were actually operated. Nephrectomy was performed in 9 patients and partial nephrectomy was performed in 3 patients. Treatment consisted of UPJ plasty in 2 cases, uretero-caliceal anastomosis in one case, stone surgery in 4 cases and suture of ruptured renal pelvis in one case. The postoperative course was marked by the development of a urinary fistula in 1 patient, cured by drainage and deterioration of hydronephrosis in one patient. Lastly, one patient died from Wilms' tumour. This disease therefore tends to have a fairly benign course, which nevertheless depends on the underlying renal disease.
作者报告了一项回顾性研究，在总共156例肾外伤病例中，有34例钝性肾外伤累及病理性肾脏。患者年龄在3岁至60岁之间，男性居多（性别比：2.4）。外伤的主要原因是家庭事故，共15例（44%）。临床特征以血尿和疼痛为主。潜在的肾脏疾病以肾结石（15例，44%）和肾盂输尿管连接部（UPJ）异常（10例，29%）为主。12例轻度外伤且潜在肾脏疾病轻微的患者接受了保守治疗。其余22例患者需要手术治疗，但实际仅20例进行了手术。9例患者接受了肾切除术，3例患者接受了部分肾切除术。治疗包括2例行UPJ成形术、1例行输尿管肾盂吻合术、4例行结石手术、1例行破裂肾盂缝合术。术后过程中，1例患者出现尿瘘，经引流治愈；1例患者肾积水恶化。最后，1例患者死于肾母细胞瘤。因此，这种疾病往往病程较为良性，但仍取决于潜在的肾脏疾病。
