중증 신손상의 보존적 요법: 위험인자 및 장단기 합병증
Conservative Management of Blunt Major Renal Lacerations: Risk Factors Versus the Short-term and Long-term Complications
최호철, 박철희, 최구택, 변인수,
소속 상세정보
최호철 ( )
계명대학교
박철희 ( )
계명대학교
최구택 ( )
계명대학교
변인수 ( )
계명대학교
KMID : 0358319920330030498
Abstract
Management of all but the minor forms of renal injury caused by blunt trauma is still somewhat controversial. A generally aggressive early operative approach is advocated in some centers, while a more watchful conservative approach is endorsed in
others. In a review of 66 patients with blunt major renal lacerations, 16 patients(24%) could not be stabilized and they subsequently underwent emergency laparotomy. Remaining 50 patients who sustained a renal laceration extending through the
corticomedullary junction following blunt trauma underwent an attempt at conservative management. Two major categories existed among these 50 patients: (1) 18 patient with devascularized renal fragments (avascular group) and (2) 32 in whom a
fragment of
the kidney was vascularized (vascular group). Complication accounted for 83 percent of the avascular group and vascular group for 25 percent. The delayed nephrectomy rate with avascuar group was markedly highr than reported in vascular group (72
percent
in avascular group. none in vascular group) We conclude that nonoperative management of major renal lacerations associated with vascularized fragments is a proper method of treatment. However, early surgical intervention should be considered in
patients
with major renal laceration associated with devascularized fragment due to high complication rate and delayed surgical intervention rate.
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