高度钝性肾损伤的成功非手术治疗

IF 1.8 Q3 UROLOGY & NEPHROLOGY Advances in Urology Pub Date : 2016-11-27 DOI:10.1155/2016/3568076
A. May, O. Darwish, B. Dang, John J Monda, P. Adsul, J. Syed, S. Siddiqui
{"title":"高度钝性肾损伤的成功非手术治疗","authors":"A. May, O. Darwish, B. Dang, John J Monda, P. Adsul, J. Syed, S. Siddiqui","doi":"10.1155/2016/3568076","DOIUrl":null,"url":null,"abstract":"Current management of high-grade blunt renal trauma favors a nonoperative approach when possible. We performed a retrospective study of high grade blunt renal injuries at our level I trauma center to determine the indications and success of nonoperative management (NOM). 47 patients with blunt grade IV or V injuries were identified between October 2004 and December 2013. Immediate operative patients (IO) were compared to nonoperatively managed (NOM). Of the 47 patients, 3 (6.4%) were IO and 44 (95.6%) NOM. IO patients had a higher heart rate on admission, 133 versus 100 in NOM (P = 0.01). IO patients had a higher rate of injury to the renal vein or artery (100%) compared to NOM group (18%) (P = 0.01). NOM failed in 3 of 44 patients (6.8%). Two required nonemergent nephrectomy and one required emergent exploration resulting in nephrectomy. Six NOM patients had kidney-related complications (13.6%). The renal salvage rate for the entire cohort was 87.2% and 93.2% for NOM. Nonoperative management for hemodynamically stable patients with high-grade blunt renal trauma is safe with a low risk of complications. Management decisions should consider hemodynamic status and visualization of active renal bleeding as well as injury grade in determining operative management.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2016 1","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2016-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/3568076","citationCount":"17","resultStr":"{\"title\":\"Successful Nonoperative Management of High-Grade Blunt Renal Injuries\",\"authors\":\"A. May, O. Darwish, B. Dang, John J Monda, P. Adsul, J. Syed, S. Siddiqui\",\"doi\":\"10.1155/2016/3568076\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Current management of high-grade blunt renal trauma favors a nonoperative approach when possible. We performed a retrospective study of high grade blunt renal injuries at our level I trauma center to determine the indications and success of nonoperative management (NOM). 47 patients with blunt grade IV or V injuries were identified between October 2004 and December 2013. Immediate operative patients (IO) were compared to nonoperatively managed (NOM). Of the 47 patients, 3 (6.4%) were IO and 44 (95.6%) NOM. IO patients had a higher heart rate on admission, 133 versus 100 in NOM (P = 0.01). IO patients had a higher rate of injury to the renal vein or artery (100%) compared to NOM group (18%) (P = 0.01). NOM failed in 3 of 44 patients (6.8%). Two required nonemergent nephrectomy and one required emergent exploration resulting in nephrectomy. Six NOM patients had kidney-related complications (13.6%). The renal salvage rate for the entire cohort was 87.2% and 93.2% for NOM. Nonoperative management for hemodynamically stable patients with high-grade blunt renal trauma is safe with a low risk of complications. Management decisions should consider hemodynamic status and visualization of active renal bleeding as well as injury grade in determining operative management.\",\"PeriodicalId\":7490,\"journal\":{\"name\":\"Advances in Urology\",\"volume\":\"2016 1\",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2016-11-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1155/2016/3568076\",\"citationCount\":\"17\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Advances in Urology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2016/3568076\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Urology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2016/3568076","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 17

摘要

目前对于高级别钝性肾外伤的治疗在可能的情况下倾向于非手术方法。我们在我们的一级创伤中心对高度钝性肾损伤进行了回顾性研究,以确定非手术治疗(NOM)的适应症和成功。2004年10月至2013年12月间,47例钝性IV级或V级损伤。将立即手术患者(IO)与非手术患者(NOM)进行比较。47例患者中,3例(6.4%)为IO, 44例(95.6%)为NOM。IO患者入院时心率较高,133例高于100例(P = 0.01)。IO组肾静脉或动脉损伤率(100%)高于NOM组(18%)(P = 0.01)。44例患者中有3例(6.8%)失败。2例需要非紧急肾切除术,1例需要紧急探查导致肾切除术。6例NOM患者出现肾脏相关并发症(13.6%)。整个队列的肾保留率为87.2%,NOM为93.2%。对血流动力学稳定的高级别钝性肾外伤患者进行非手术治疗是安全的,并发症风险低。管理决策应考虑血流动力学状态和活动性肾出血的可视化以及确定手术管理的损伤等级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Successful Nonoperative Management of High-Grade Blunt Renal Injuries
Current management of high-grade blunt renal trauma favors a nonoperative approach when possible. We performed a retrospective study of high grade blunt renal injuries at our level I trauma center to determine the indications and success of nonoperative management (NOM). 47 patients with blunt grade IV or V injuries were identified between October 2004 and December 2013. Immediate operative patients (IO) were compared to nonoperatively managed (NOM). Of the 47 patients, 3 (6.4%) were IO and 44 (95.6%) NOM. IO patients had a higher heart rate on admission, 133 versus 100 in NOM (P = 0.01). IO patients had a higher rate of injury to the renal vein or artery (100%) compared to NOM group (18%) (P = 0.01). NOM failed in 3 of 44 patients (6.8%). Two required nonemergent nephrectomy and one required emergent exploration resulting in nephrectomy. Six NOM patients had kidney-related complications (13.6%). The renal salvage rate for the entire cohort was 87.2% and 93.2% for NOM. Nonoperative management for hemodynamically stable patients with high-grade blunt renal trauma is safe with a low risk of complications. Management decisions should consider hemodynamic status and visualization of active renal bleeding as well as injury grade in determining operative management.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Advances in Urology
Advances in Urology UROLOGY & NEPHROLOGY-
CiteScore
2.90
自引率
0.00%
发文量
17
审稿时长
15 weeks
期刊介绍: Advances in Urology is a peer-reviewed, open access journal that publishes state-of-the-art reviews and original research papers of wide interest in all fields of urology. The journal strives to provide publication of important manuscripts to the widest possible audience worldwide, without the constraints of expensive, hard-to-access, traditional bound journals. Advances in Urology is designed to improve publication access of both well-established urologic scientists and less well-established writers, by allowing interested scientists worldwide to participate fully.
期刊最新文献
Initial Experience of Contact Laser Vaporization of the Prostate (CVP) for Benign Prostate Hyperplasia Patients With Hemorrhagic Risk. Racial Disparities in Clinical Trial Enrollment Among Patients Diagnosed With Prostate Cancer: A Population-Based Cohort of Oncology Practices. A Review of Electronic Early Warning Systems for Acute Kidney Injury. Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer. Complications and Influential Perioperative Factors Associated with SpaceOAR Hydrogel Placement.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1