Experience with Managing Renal Trauma

腎臟外傷的處理經驗

黃懷恩(Wai-Yan Wong) ； 陳永泰(Yung-Tai Chen) ； 楊緒棣(Stephen Shei-Dei Yang) ； 謝政興(Cheng-Hsing Hsieh) ； 王炯珵(Chung-Cheng Wang)

《中華民國泌尿科醫學會雜誌》 12卷4期 (2001/12) Pp. 171-175

https://doi.org/10.7024/JUAROC.200112.0171

摘要

研究目的: 我們分析近兩年來所發生的腎臟外傷個案及處理情形，並回顧文獻以做為處理此類患者之參考腹部受傷的病人。
材料與方法: 自1998到2000年，一共有10位腎臟外傷患者到本院接受治療，其中五位輕度外傷（第一至二級）患者全都接受保守療法，另五位為重度外傷（第三至五級），其中二人接受利用vicryl mesh bag 做保留性腎臟修補手術，另外三人則進行腎臟摘除術。
結果:五位接受保守療法及二位接受保留性腎臟修補手術者，術後皆恢復良好，術後三個月的靜脈腎盂攝影及超音波追蹤，皆顯示不錯的影像結果。
結論: 對於輕度外傷患者採取保守療法，往往都有滿意的效果，而利用vicryl mesh bag做保留性腎臟修補手術，對於重度外傷而言，不失為一種不錯的選擇。

關鍵字

腎臟外傷

並列摘要

OBJECTIVE: The purpose of this study was to analyze cases of renal trauma encountered in our hospital in the last 2years and review the literature regarding the appropriate management of renal trauma to ensure better treatment in future practice.
MATERIALS AND METHODS: From April 1998 to May 2000, a total of 10 patients with renal trauma was admitted with an average age of 44.1 years. Patients were equally classified as laving minor (grades I and II) or major injury (grades III-V). 5 patients with minor injury were treated conservatively. 2patients with grade IV injury underwent renorrhaphy with a mesh bag. Nephrectomy was inevitable in 3 patients with 2 of grade V injury and 1 of grade III but with and associated polycystic kidney whose bleeding source was difficult to identify.
RESULTS: Of the 5 patients with minor injury and nonoperative treatment and the 2 cases with grade IV injury who underwent renorrhaphy with mesh bag repair, all recovered uneventfully and were discharged without sequelae. Both IVU and color Doppler ultrasonography at 3-month intervals showed satisfactory results in all 5 patients who underwent conservative treatment and the 2 with vicryl mesh repair.
CONCLUSIONS: Preserving kidneys with conservative treatment in patients with minor injury is often successful, and vicryl mesh bag repair is rapid and effective in our experience for major injury.

並列關鍵字

renal trauma