KẾT QUẢ SỚM CỦA 33 TRƯỜNG HỢP ĐIỀU TRỊ BẢO TỒN Ở BỆNH NHÂN CHẤN THƯƠNG THẬN KÍN TẠI THÀNH PHỐ CẦN THƠ

Abstract

Background: Renal injury is the most common pathology in trauma to the urinary tract system. Comprehensive clinical assessment, combining abdomen ultrasound scan, computed tomography to classify the extent of renal damage, and other specific clinical tests allow clinicians to boldly make decisions on conservative treatment of renal injuries more than ever, even severe injury, with high efficiency. Objective: To study on clinical, para-clinical characteristics and to evaluate the results of conservative treatment for renal injury. Materials and methods: Describe a series of cases according to the recommended approach. After initial assessment and resuscitation, 33 hemodynamically stable renal injury patients will have blood analysis; do abdomen ultrasound scan and computed tomography scan to evaluate the extent of renal injury and other combined body damages. Monitor and evaluate progression of clinical signs. Indicate intervention when clinical manifestations gotten worse. Results: The rate of conservative treatment to preserve the kidney was 81.9%, conservative treatment with vascular intervention was 12%, nephrectomy with 2 patients was 6.1% due to worse clinical progression.  The rate of successful kidney preservation treatment was 93.9%. Although grade IV severe renal injury accounted for 18.2%. Conclusion: Conservative treatment for renal injury with stable hemodynamics is safe, with low risk of complications. The rate of successful conservative treatment of renal injury is high. The decision had conservative treatment for renal injury with intervention or surgery is based on hemodynamics, blood loss and injury grading.