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目的:探讨新损伤严重度评分(NISS)在肾损伤治疗方案选择及预后判断中的意义。方法:采用NISS对186例肾损伤患者治疗方案的选择及转归进行回顾性分析及评估。结果:开放性损伤手术探查率高于闭合性损伤(P<0.01),开放性损伤与闭合性损伤NISS差异无统计学意义(P>0.05);NISS评分与治疗方案有关,手术率及肾切除率随NISS增加而增加,各组间差异有统计学意义(均P<0.05);随损伤部位数增加,损伤程度加重,NISS值升高,死亡率也升高(P<0.05)。结论:NISS总分<15分的伤情一般较轻,经保守治疗多可痊愈;NISS总分在15~34分之间,损伤程度为中度,推荐积极手术抢救;NISS总分在35~49分多为重型复合伤,建议在纠正休克及改善全身情况的基础上选择手术治疗,总分≥50分者不建议手术。
Objective: To explore the significance of the new injury severity score (NISS) in treatment options and prognosis of renal injury. Methods: The selection and outcome of 186 cases of renal injury patients treated with NISS were retrospectively analyzed and evaluated. Results: The detection rate of open injury surgery was higher than that of closed injury (P <0.01), but there was no significant difference between open injury and closed injury NISS (P> 0.05). The NISS score was related to the treatment plan. The operative rate and nephrectomy The rate of NISS increased with the increase of NISS (P <0.05). With the increase of the number of injury sites, the degree of injury increased, the NISS increased and the mortality increased (P <0.05). CONCLUSIONS: The scores of NISS total score <15 points are generally mild and can be cured by conservative treatment. The NISS score is between 15 and 34 points, and the degree of injury is moderate. Active surgical resection is recommended. The score of NISS is 35 ~ 49 points for the more complex injury, it is recommended to correct shock and improve the general condition based on the choice of surgical treatment, the total score ≥ 50 points are not recommended surgery.