背景:在泌尿生殖系统创伤中,对肾脏的钝性损伤是最常见的:对它们的初始处理已经进行了很好的研究,但是它们在远处的发展记录很少。这项研究的目的是评估钝性肾损伤的晚期并发症,并探讨其发生的预测因素。
方法:对TraumAFUF项目进行了回顾性观察研究,包括,在2005年至2018年期间,所有钝性肾损伤均在18家法国医院接受治疗,随访时间超过3个月.最初创伤的特征,以及三个月后发生的任何并发症,已确定。患者分为两组:晚期并发症(LC)或无并发症(UC)。在单因素和多因素分析中比较两组,以确定发生这些并发症的危险因素。
结果:在包括的454名患者中,50与LC(11%),作为症状性形态学改变的肾脏(2.9%),继发性生物肾功能受损(2.9%),或继发性动脉高血压(2.4%)。确定的危险因素是,在最初的医疗护理中,高度肾损伤≥IV(OR=2.4,P=0.025),活动性出血(OR=2.6,P=0.007),输血的需要(OR=2.3,P=0.001),或介入治疗(R=1.7,P=0.09)或内镜治疗(OR=2.0,P=0.035)。
结论:在这项研究中,11%的病例在钝性肾损伤后发生晚期并发症。所确定的风险因素使得有可能绘制患者概况,这些患者将从长期随访中受益以检测这些并发症。
方法:
BACKGROUND: Among genitourinary traumas, blunt trauma to the kidney are the most frequent: their initial management has been well studied but their development at a distance is poorly documented. The objective of this
study was to assess the late complications of blunt renal trauma, and to investigate their predictive factors for occurrence.
METHODS: A retrospective observational
study of the TraumAFUF project was conducted, including, between 2005 and 2018, all blunt renal trauma treated in 18 French hospitals and followed for more than 3 months. The characteristics of the initial trauma, as well as any complications occurring after three months, were identified. The patients were divided into two groups: onset of a late complication (LC) or uncomplicated (UC). The groups were compared in univariate and multivariate analyses to identify the risk factors for the occurrence of these complications.
RESULTS: Among the 454 patients included, 50 presented with LC (11%), as symptomatic morphologically altered kidney (2.9%), secondarily impaired biological renal function (2.9%), or secondary arterial hypertension (2.4%). The risk factors identified were, during initial medical care, a high-grade renal trauma≥IV (OR=2.4, P=0.025), active bleeding (OR=2.6, P=0.007), the need for transfusion (OR=2.3, P=0.001), or interventional (R=1.7, P=0.09) or endoscopic treatment (OR=2.0, P=0.035).
CONCLUSIONS: In this
study, late complications occurred in 11% of cases after blunt renal trauma. The risk factors identified make it possible to draw up a patient profile who would benefit from prolonged follow-up to detect these complications.
METHODS: