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目的：探讨重度肾损伤的切肾原因，提高保肾率。方法：对 ５８ 例重度肾损伤作肾切除者进行回顾性分析。结果：肾碎裂伤、横断伤、肾蒂伤 ２２ 例（３７．９％ ），肾全层裂伤３３ 例（５６．９％ ），病理性肾损伤３ 例（５．２％ ）。结论：患者损伤程度重、全身状况差、有合并伤及延迟手术是构成肾切除的主要原因；积极改善患者全身状况，正确估计损伤的病理类型，尽早修复肾脏裂口，对非手术治疗效果不佳者，争取在 ７２ ｈ 内手术探查，是减少重度肾损伤切肾率的关键。
Objective: To investigate the causes of kidney failure in severe renal injury and improve the rate of invigorating kidney. Methods: Fifty-eight cases with severe renal injury undergoing nephrectomy were retrospectively analyzed. Results: There were 22 cases (37.9%) of renal pedicle trauma, transverse transection, renal pedicle injury, 33 cases (56.9%) of renal full thickness laceration and 3 cases (5.2%) of pathological renal injury. CONCLUSIONS: The severity of injury, poor general condition, combined injury and delayed operation are the main causes of nephrectomy. Active improvement of the general condition of the patient, correct assessment of the pathological type of injury, early repair of renal neoplasm, and ineffective non-surgical treatment Those who strive for surgical exploration within 72 h are the key to reducing the incidence of severe renal injury and cutting the kidney.