腎外傷103例の臨床的観察

Abstract

過去13年間の経験である.男87, 女16例であり, また10～19歳に28例と多発していた.原因は, 交通事故が55例を占め, 以下転落16例, 一般外傷11例, スポーツ外傷8例, 労働災害7例, 暴力6例の順であった.合併損傷は54例にみられ, 胸部外傷, 腰椎横突起骨折, 頭部外傷, 四肢骨骨折, 腹部外傷の順であった.治療法別では102例中保存的治療95例(97病腎), 腎摘5例, 腎周囲ドレナージ法2例であり, 合併損傷に対しても9例に外科的治療を行った.後遺症としては, 一応治療後, 少なくも6ヵ月以上観察し得た保存的治療(腎周囲ドレナージ法1例を含む)41例ついて, 中等度腎破裂7例中1例に腎杯鈍円化を, 高度腎破裂8例中1例に腎結石, 1例に中・下腎杯変形を, また腎断裂4例中1例に下腎杯変形, 2例に無機能腎, 1例に腎結石がみられた

Between 1971 and 1983, 103 patients with renal injury were admitted to the Department of Urology, Tatebayashi Kosei Hospital. There were 87 males and 16 females. The most frequent age group seen (27.2% of patients) was the 10 to 19 year group. The various causes included traffic accidents (55 patients), falls (16 patients), athletic injuries (8 patients), labor accidents (7 patients), blows (6 patients) and others (11 patients). Associated injuries were present in 52.4% of the patients, including thoracic injuries such as rib fracture (20 patients), lumbar vertebra and transverse process fractures (18 patients), and head injuries (12 patients). Evaluation of the renal injuries was made by excretory urogram (IVP) and conservative management was for most, contusion and rupture, and operation for laceration as a principle: 95 patients (97 renal injuries) were treated by conservative management and 7 patients were treated surgically, 5 patients by nephrectomy and 2 patients by perirenal drainage. Nine patients who had associated injuries were treated surgically. In the follow-up study of 41 patients who had received conservative management and operation (perirenal drainage), followed for more than 6 months and had IVP, urinalysis and blood pressure measurement, representative changes were calyceal deformity (3 patients), renal calculus formation (2 patients) and non-functioning kidney (2 patients) in urograms.