最新《肾损伤》课件.ppt
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- 肾损伤 最新 损伤 课件
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1、肾损伤肾损伤ppt课件课件Function of the kidneylProduce urine,excrete metabolites lMaintain body fluid and acid-base balance lEndocrine function:Renin,prostaglandinl Regulate blood pressure and balance blood lipidslEndocrine degrading hormoneBackgroundInjuries to urinary systemlAbout 10%of all injuries in the e
2、mergency room involve the genitourinary systemlMany of them are difficult to definelEarly diagnosis is essential to prevent serious complicationsBackgroundlBasic Pathological change Shock Urinary extravasation Urinary obstruction(destruction)Infection,cost,deathAnatomylKidneylUreterlBladderlUrethraU
3、rlThe kidney is well protected by heavy lumbar muscles,vertebral bodies,ribs,and the viscera anteriorlyEtiology lBlunt trauma directly to the abdomen,flank,or back is the most common mechanism for 8085%renal injurieslTraffic accidents,fights,falling,contact sports,and so on.lBlunt trauma:The force t
4、ransmitted from the center of the impact to the renal parenchymalDeceleration:The kidney moves upward or downward,cause sudden stretch on the pedicle,acute renal artery injuries and thrombosis may occurlDirect or indirect violence at upper abdomen or flank area may cause kidney injure lFracture ribs
5、 and transverse vertebral processes may penetrate the renal parenchyma or vasculaturelGunshot and knife wounds cause penetrating injuries to the kidney*Pathology lRenal contusion (85%of cases)Superficial cortical lacerationsSubcapsular hematoma lPartial lacerationsInjuries extend to renal capsule or
6、 collecting systemPerirenal hematomaHematurialDeep lacerationsInjuries extend both renal capsule and collecting systemExtravasation of urine into perirenal spaceLarge retroperitoneal hematomaHematurialVascular injury(less than 1%)Vascular injury of renal pedicle is rareDifficult to diagnosisEmergenc
7、y operation should be done for saving lifeMortality is still highClinical findingslHistory of traumalSymptoms:Pain may be localized to one flank area or over the abdomen associated to injuryMicroscopic or gross hematuria following trauma to the abdomen or flankFever:infectionlSignsShock or signs of
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