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我院自1970年1月～1987年12月收治肾全层裂伤15例,均采用铆钉式缝合法修复,获得满意的临床效果15例中,男13例,女2例。年龄17～51(平均30.4)岁。肾脏直接刀刺伤2例,腰背或上腹部暴力致伤13例。右肾上极全层裂伤6例,下极全层裂伤2例;左肾上极全层裂伤5例,下极全层裂伤2例。合并肋骨、脊椎椎体骨折1例,脾脏损伤6例,肝脏损伤2例,胃肠道损伤2例,左肾静脉撕裂伤1例。全部病例均有大量全程肉眼血尿、伤侧腰部血肿,13例伴有休克。均经8～12小时输血、输液等抗休克治疗,因休克未纠正或肉眼血尿加重,腰部肿块进行性增大而急行手术探查。除2例因刀刺伤经腰背途径探查外,余因内出血而经腹途径。清除肾区或腹腔内积血及处理腹腔脏器复合伤后,发现肾区巨大后腹膜血肿,探查该处并清除血肿,发现肾上极或下极全层裂伤伴活动性出血,均采用熊旭林介绍的铆钉式缝合法修复肾组织裂伤。术后无继发性出血及肾周感染。
Our hospital from January 1970 to December 1987, 15 cases of full thickness laceration of the kidney were treated with rivet suture repair, to obtain satisfactory clinical results in 15 cases, 13 males and 2 females. Age 17 ~ 51 (average 30.4) years old. 2 cases were stabbed directly by the kidney and 13 cases were injured by violence on the back or upper abdomen. 6 cases of right upper renal all-layer laceration, 2 cases of lower full thickness laceration, 5 cases of upper left whole kidney laceration, 2 cases of lower full thickness laceration. 1 case of rib fracture, vertebral vertebral fracture, 6 cases of spleen injury, 2 cases of liver injury, 2 cases of gastrointestinal tract injury, 1 case of left renal vein laceration. All cases have a large amount of gross hematuria, injury of the side of the waist hematoma, 13 cases with shock. After 8 to 12 hours of blood transfusions, transfusion and other anti-shock treatment, due to shock uncorrected or gross hematuria, lumbar mass progressively increased and emergency surgical exploration. In addition to 2 cases stab wounds by the lumbar and back path exploration, I due to internal bleeding and abdominal pathways. Removal of renal or intraperitoneal hemorrhage and the treatment of abdominal viscera complex injury and found a huge retroperitoneal hematoma in the kidney area, exploration and removal of hematoma and found that the upper pole or lower pole full thickness laceration with active bleeding, are used Xiong Xulin introduction of rivet suture repair renal tissue injury. No postoperative secondary hemorrhage and perirenal infection.