腎外傷の臨床的統計

Abstract

1988年～1996年に聖マリアンナ医科大学にて経験した腎外傷64例について臨床的検討を加えた.治療の問題点となるII型, III型の症例に対しては一致した見解が得られていないが, TAEでも止血しえない持続する出血例以外は, 保存的治療で特に重篤な合併症や後遺症も認めず, 腎機能も維持できていた.以上より, II型, III型の腎外傷において, vital安定した症例については, 手術の必要性はないものと考えた

A total of 64 patients with renal trauma were treated at the Department of Urology, St. Marianna University School of Medicine, from January 1988 to December 1996. Patients were between 3 and 66 years old (mean 28.2); 56 (87.5%) of them were male and 8 (12.5%) were female. The main cause of injury was a traffic accident in 33 cases (51.6%). According to the Classification of Renal Injury by the Japanese Association for the Surgery of Trauma in Japan, there were 27 cases (42.2%) of Type I (subcapsular injury), 12 cases (18.8%) of Type II (superficial injury), 16 cases (25.0%) of Type III (Deep injury), 6 cases (9.4%) of Type IV (Pedicle injury). Surgical treatment was performed in 6 cases (9.3%). The major associated injuries were bone fracture in 33 cases (51.6%), lung injury in 20 cases (31.3%) and liver injury in 16 cases (25.0%). The literature is also reviewed briefly.