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目的 探讨老年人闭合性肾外伤的特点及总结治疗经验。 方法 对我院从 1985年1月至 2 0 0 1年 12月收治的 132例闭合性肾外伤患者进行分组 ,71例 6 0岁以下者为中青年组 ,6 1例6 0岁以上者 (含 6 0岁 )为老年组。将所有肾损伤进行分级 ,并对同级的肾损伤治疗后效果进行比较。 结果 两组所有Ⅰ、Ⅱ级肾损伤经保守治疗后均获满意效果。在Ⅲ、Ⅳ级的肾损伤处理中 ,老年组手术探查率 (39 3% )低于中青年组 (5 3 3% ) ,但老年组伤肾保存率 (86 9% )高于中青年组 (71 8% )。在Ⅴ级的肾损伤治疗中 ,两组肾切除率相同 ,老年组有 2例肾功能进行减退 ,而中青年组未出现。 结论 老年肾的代偿功能差 ,在老年人闭合性肾损伤的治疗中 ,应最大限度地保护有功能的肾组织及对侧肾脏功能。
Objective To investigate the characteristics of closed renal trauma in the elderly and to summarize the experience of treatment. Methods A total of 132 patients with closed renal trauma admitted to our hospital from January 1985 to December 2001 were enrolled in this study. Of the 71 patients younger than 60 years of age, 61 were younger than 60 years ( Including 60 years old) for the elderly group. All kidney injuries were graded and compared for post-treatment effects of renal injury at the same level. Results All patients with grade Ⅰ and Ⅱ renal injury in both groups received satisfactory results after conservative treatment. Surgical exploration rate in the elderly group was lower than that in the middle-aged group (53.3%), but the renal injury rate in the elderly group was 86.9% higher than that in the middle-aged group (71 8%). In grade Ⅴ renal injury treatment, the two groups of the same rate of nephrectomy, 2 cases of elderly patients with renal function decline, while the young group did not appear. Conclusion Elderly renal compensatory function is poor, in the treatment of closed renal injury in the elderly, should maximize the protection of functional renal tissue and contralateral kidney function.