Munk M, Hofmockel G, Frohmüller H
Urologische Klinik und Poliklinik, Universität Würzburg.
Urologe A. 1997 Nov;36(6):531-4. doi: 10.1007/s001200050132.
Forty-two patients with blunt renal injuries were treated between 1984 and 1994 at our institution. Twenty-nine patients revealed a contusion (grade I injury), 10 showed lacerations (grade II), 1 a severe fracture (grade III), and 2 presented pedicle injuries (grade IV). All 10 patients with incomplete renal injuries (grade II) were treated conservatively, i.e. without primary surgery. One of these 10 patients required surgical intervention 3 months after the trauma due to a urinary obstruction. Two of the ten patients with grade II injuries suffered late complications, namely a contracted kidney in one case and hypertension in the other. This means that of 10 patients with conservatively treated grade II renal trauma, a loss of the function of the affected kidney occurred in only one. In 9 patients complete function of the kidney could be preserved. In conclusion, conservative management of incomplete blunt renal injuries is an effective treatment option with few complications.
1984年至1994年间,我院共治疗了42例钝性肾损伤患者。29例患者为肾挫伤(I级损伤),10例为肾裂伤(II级),1例为严重骨折(III级),2例为肾蒂损伤(IV级)。所有10例不完全性肾损伤(II级)患者均接受保守治疗,即未进行一期手术。这10例患者中有1例在创伤后3个月因尿路梗阻需要手术干预。10例II级损伤患者中有2例出现晚期并发症,1例为肾萎缩,另1例为高血压。这意味着,在10例接受保守治疗的II级肾创伤患者中,仅1例受影响肾脏功能丧失。9例患者的肾脏功能得以完全保留。总之,对不完全性钝性肾损伤进行保守治疗是一种有效的治疗选择,并发症较少。