Carl P
Urologische Klinik, Klinikum Deggendorf.
Urologe A. 1997 Nov;36(6):523-30. doi: 10.1007/s001200050131.
A dynamic helical CT scan following initial ultrasound provides reliable radiological staging for kidney traumas and immediate diagnosis of most abdominal injuries. It also proves useful for pediatric traumas. Using mainly CT data we apply a classification system proposed by the American Association for Surgery of Trauma (grade I-V). The diagnostic steps and subsequent management are demonstrated by flow-chart. Most renal traumas may be treated conservatively but persistent bleeding or persistent urinary extravasation may necessitate surgical intervention. In cases of exploration of the kidney, the use of fibrin adhesive, alloplastic mesh capsule and DJ stents enables the reconstruction of the kidney. Exploration of the renal injury should never be omitted if urgent laparotomy is indicated for associated injuries.
初始超声检查后进行的动态螺旋CT扫描可为肾外伤提供可靠的放射学分期,并能对大多数腹部损伤进行即时诊断。它对儿科创伤也很有用。我们主要利用CT数据应用美国创伤外科协会提出的分类系统(I - V级)。诊断步骤及后续处理通过流程图展示。大多数肾外伤可保守治疗,但持续出血或持续尿外渗可能需要手术干预。在肾脏探查的病例中,使用纤维蛋白粘合剂、异体网胶囊和DJ支架可实现肾脏重建。如果因相关损伤需要紧急剖腹手术,肾损伤的探查绝不能省略。