복부둔상에 의한 신손상 환자의 임상적 고찰
Clinical Evaluation of Blunt Renal Trauma
이호승, 권경일, 염규영,
소속 상세정보
이호승 ( )
을지의과대학 비뇨기과학교실
권경일 ( )
을지의과대학 비뇨기과학교실
염규영 ( )
을지의과대학 비뇨기과학교실
KMID : 0358319980390070638
Abstract
서론
산업의 고도화와 자동차의 증가 및 다양한 레저스포츠의 보급으로 인해 신손상 환자의 발
생빈도가 증가하고 있다. 대부분의 신손상 원인은 교통사고 및 산업장에서의 안전사고 등이
며, 따라서 보상과 관련된 법적인 문제가 관련될 경우가 많기 때문에 정확한 진단 및 치료
가 필요하다 따라서 저자들은 신손상 환자의 적절한 진단방법과 치료방침을 알기 위하여 최
근 6년간 본원에 내원한 신손상 환자들 중에서 복부둔상에 의해 신손상을 받은 103명을 대
상으로 손상의 원인 동반손상여부, 혈뇨의 정도, 방사선소견 및 치료방법 등을 분석하였다.
#초록#
Purpose : The evaluation of patients with suspected blunt renal trauma relies mainly
on clinical assessment, urinalysis and imaging studies. For the evaluation of the effects
of various factors in patients with blunt renal trauma, we performed this study.
Materials and Methods : We retrospectively reviewed the medical records of 103
patients who presented to our hospital with blunt renal trauma between 1991 and 1996.
Results: A total of 103 patients presented to our hospital with suspected blunt renal
trauma. There were 72 male and 31 female between 8 and 82 years old (mean 35.7).
Traffic accident was the most common cause of injury, accounting for 54.4%(56 cases).
The remaining injuries were caused by falls in 30 cases (29.1%), assault in 15(14.6%)
and sports-related trauma in 2(1.9%). Renal injuries were classified as established by
the Organ Injury Scaling Committee of the American Association for the Surgery of
Trauma in 1989. There were 61 cases(59.2%) grade I, 15(14.6%) grade II, 8(7.8%) grade
III, II(10.6%) grade IV and 8(7.8%) grade V. Of the 103 patients 58 had microscopic
hematuria and 40 had gross hematuria. We found that the degree of hematuria does not
correlate with the severity of renal injury. 54 patients(52.4%) had a total of 69
associated injuries, including extremity fracture In 21, rib fracture in 14, pelvic fracture
in 14, liver injury in 6, closed head injury in 6, spinal fracture in 3, bowel injury in 3
and spleen injury in 2. Surgical exploration was required in 15 patients(14.6%) for renal
or associated injuries.
Conclusions : We should be managed blunt renal injuries with a consistent approach
based on accurate injury definition from clinical, radiographic, and sometimes surgical
staging. Accurate renal injury staging was essential to successful management of
traumatized patients.
(Korean J Urol 1998; 39: 638∼42)
키워드
Blunt trauma; Renal injury;
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