腹腔镜手术治疗Ⅳ级肾破裂合并肾静脉血栓及肝破裂1例报告  

Laparoscopic surgery for kidney gradeⅣrupture combined with renal vein thrombosis and liver rupture:a case report

作　　者：赵瑞 刘瑞剑[1] 邢志强[1] 闫伟[1] 王洪尉 张瑞东 马潞林[2] Zhao Rui;Liu Ruijian;Xing Zhiqiang;Yan Wei;Wang Hongwei;Zhang Ruidong;Ma Lulin(Department of Urology,Ordos Central Hospital,Ordos 017010,China;Department of Urology,Peking University Third Hospital,Beijing 100089,China)

机构地区：[1]鄂尔多斯市中心医院泌尿外科,鄂尔多斯017010 [2]北京大学第三医院泌尿外科,北京100089

出　　处：《中华泌尿外科杂志》2025年第2期143-144,共2页Chinese Journal of Urology

摘　　要：本文报道1例男性患者,34岁。2023年10月6日因高空坠落伤入院。查体:血压96/53 mmHg(1 mmHg=0.133 kPa),心率105次/分,右肾区稍隆起,右肾区叩击痛阳性。CT检查:右肾下极完全破裂,右肾静脉血栓形成,肝右后叶挫裂伤。根据美国创伤外科协会肾损伤分级诊断为Ⅳ级肾破裂。经输血、补液后生命体征平稳。行腹腔镜肾切除术+肾静脉血栓切除术+肝破裂修补术。手术时间90 min,术中吸出血块和鲜血约300 ml。术后患者生命体征平稳,术后3 d可下床活动。术后1个月复查CT:右肾切除术后,肝愈合良好。在患者生命体征平稳的前提下,该术式是可行的,其优势是手术切口小、时间短、出血少,术后患者恢复快,手术效果良好。A 34-year-old male patient was admitted to the hospital on October 6,2023 due to fall from a high place.Physical examination showed blood pressure 96/53 mmHg(1 mmHg=0.133 kPa),heart rate of 105 beats/min,slight bulge in the right kidney area,and positive percussion pain in the right kidney area.CT examination showed complete rupture of the lower pole of the right kidney,thrombosis of the right renal vein,and contusion and laceration of the right posterior lobe of the liver.According to the American Association for the Surgery of Trauma renal injury classification,he was diagnosed as gradeⅣrenal rupture.After blood transfusion and fluid infusion,vital signs were stable.Laparoscopic nephrectomy plus renal vein thrombectomy plus liver rupture repair were performed.The operation took 90 minutes,and about 300 ml of blood clots and fresh blood were aspirated during the operation.The patient's vital signs were stable after the operation,and he could get out of bed 3 days after the operation.CT reexamination 1 month after the operation showed right kidney resected and the liver healed well.This operation is feasible if the patient's vital signs are stable,with the advantages of small surgical incision,short operation time,less bleeding,fast postoperative recovery and good surgical effect.

关 键 词：腹腔镜 肾破裂 肾静脉血栓 肝破裂 

分 类 号：R73[医药卫生—肿瘤]