目的：总结闭合性肾损伤的诊断与治疗。方法回顾性分析168例闭合性肾损伤患者的诊治资料。结果168例均行尿液常规检查，血尿149例(88.7%)；B 超检查154例，阳性131例(85.1%)；CT检查118例，阳性118例(100.0%)，静脉尿路造影(IVU)检查28例，阳性19例(67.9%)；保守治疗132例(78.6%)，手术36例(21.4%)，治愈165例，死亡3例。其中106例随访12~60个月，尿常规、肾功能、血压表现正常。结论闭合性肾损伤初步检查首选B超， CT评估肾损伤程度和分型最准确，如无严重腹腔脏器并发伤， CT检查和血流动力学指标改变表现严重时也有较大的保守治疗的可能性。%Objective To summarize the diagnosis and treatment of closed renal injury.Methods A retrospective analysis was made on the diagnosis and treatment data of 168 patients of closed renal injury. Results Conventional urinalysis was applied in all the cases, and there were 149 cases with hematuria (88.7%). B ultrasound examination was taken in 154 cases, and there were 131 positive cases (85.1%). CT examination of 118 cases showed there were 118 positive cases (100.0%). Intraudio videoenous urography was applied in 28 cases, and there were 19 positive cases (67.9%). There were 132 cases received conservative treatment (78.6%), 36 cases underwent surgery (21.4%), and 165 cases healed, with 3 cases died. The follow-up lasted for 12~60 months in 106 cases, and urinalysis, renal function, and blood pressure were all normal.Conclusion B ultrasound should be considered as the first choice in diagnosis of closed renal injury. Kidney damage degree and types are evaluated accurately by CT. If there is no severe abdominal organ concurrent injury, there is also the chance of conservative treatment under severe degree of CT and hemodynamic indexes.
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