闭合性肾脏损伤的CT诊断分型及临床价值  

CT Diagnostic Classification and Clinical Value of Blunt Renal Trauma

作　　者：钟君立[1] 丁巍[1] 谭三智[1] 

机构地区：[1]广州市第一人民医院急诊科,510180

出　　处：《中国医疗前沿》2010年第1期11-12,86,共3页China Healthcare Innovation

摘　　要：目的总结分析49例闭合性肾脏损伤的CT征象,探讨CT分型的临床价值。方法对闭合性腰部或腹部创伤患者行多层螺旋CT平扫和增强扫描,分析肾脏损伤或合并邻近脏器复合性损伤患者的CT征象。结果根据肾损伤的部位、范围和程度可将CT表现分为五型:Ⅰ型,单纯肾包膜下血肿,7例;Ⅱ型,肾实质局灶性挫伤,13例;Ⅲ型,肾实质广泛挫裂伤伴肾筋膜囊内血肿,16例;Ⅳ型,肾挫裂伤伴肾筋膜外血肿,11例;Ⅴ型,肾蒂撕裂伤,2例。结论CT能清楚显示肾损伤的范围、程度以及有无邻近脏器损伤,CT分型能为临床选择治疗方案提供重要依据。Objective To sum up the CT appearances of 49 cases of blunt renal trauma in order to explore its classification and clinical value. Methods Pro-and postcontrast multi-slice spiral CT scan were performed with patients suffered from lumbar or abdominal blunt trauma, and CT findings of 49 patients with renal trauma or accompanying with adjacent injuried organs were analyzed retrospectively. Results According to the CT features of part, range and extent of the injured kinds, the lesions could be divided into five types： （1）type Ⅰ, simple subcapsule hematoma （7 cases）; （2）type Ⅱ, partial trauma of renal parenchyma （13 cases）, （3）type Ⅲ, extensive tearing of renal parenchyma accompanying hematoma limited in the renal fascia （16 cases） ; （4）type Ⅳ, broken kidney with hematoma outside the renal fascia （11 cases）; （5）type Ⅴ, tearing of renal pedicle （2 cases）. Conclusion CT scan can dearly show the injuried parts, range and severity of blunt renal trauma, CT classification can provide essential evidence for clinical therapy.

关 键 词：肾脏 损伤 体层摄影 X线计算机 诊断 分型 

分 类 号：R691.6[医药卫生—泌尿科学] R814[医药卫生—外科学]