重度肾积水外伤后肾破裂伤病关系分析
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摘要
目的提出重度肾积水与外伤共存情况下发生肾破裂时伤病关系的分析思路。方法收集实践中遇到的1个此类案例的资料(包括案件调查材料及完整的病历资料),同时结合鉴定标准判断伤与病之间的因果关系。结果重度肾积水患者肾内张力增加引起肾实质变薄,遭受轻微外力即可发生破裂。疾病是导致破裂的主要因素,轻微外力是次要因素,不宜评定损伤程度。结论进行伤病关系分析必须收集完整的资料,尤其是用于评估外力大小的相关资料应全面收集。恰当的影像学检查是必要的。伤病关系应当在明确病情与伤情后进行客观分析。
Objective To put forward a new analytical idea on the relationship between injury and disease when occurrence was befallen into renal rupture complicated with severe hydronephrosis. Methods Based on one case of its investigation materials and complete medical records, the causal relationship was judged between injury and disease under the relevant identification criteria. Results Increased intra-renal tension will lead to thinning of the renal parenchyma in patients of severe hydronephrosis so that a slight external force can even cause the kidney to rupture. Disease is the main factor leading to rupture, with the secondary one from a slight external force that is therefore dif?cult by it to assess the degree of injury.Conclusion Complete information and materials must be collected for analysis of the relationship between injury and disease,especially on the external force about its strength magnitude. Appropriate imaging studies are necessary. Only could an objective analysis be carried out about the relationship between injury and disease after the ascertainment of the patient's condition and trauma degree.
Objective To put forward a new analytical idea on the relationship between injury and disease when occurrence was befallen into renal rupture complicated with severe hydronephrosis. Methods Based on one case of its investigation materials and complete medical records, the causal relationship was judged between injury and disease under the relevant identification criteria. Results Increased intra-renal tension will lead to thinning of the renal parenchyma in patients of severe hydronephrosis so that a slight external force can even cause the kidney to rupture. Disease is the main factor leading to rupture, with the secondary one from a slight external force that is therefore dif?cult by it to assess the degree of injury.Conclusion Complete information and materials must be collected for analysis of the relationship between injury and disease,especially on the external force about its strength magnitude. Appropriate imaging studies are necessary. Only could an objective analysis be carried out about the relationship between injury and disease after the ascertainment of the patient's condition and trauma degree.
引文
[1]范利华,吴军,牛伟新.损伤与疾病[M].上海:复旦大学出版社,2014:257-258.
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[3]肖帆,周爱云.输尿管结石合并自发性肾破裂1例[J].中国医学影像技术,2013(12):2019.
[4]谢华杰,李国伟,赵学根,等.重度肾积水感染后肾自发性破裂1例[C]//浙江省科学技术协会.2014浙江省医学会男科学泌尿外科学学术年会论文汇编,2014:272.
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[6]吕春燕,时淑燕,杨玲,等.842例肾手术患者临床病理及流行病学研究[J].西部医学,2016(2):208-211.
[7]赵定麟,李增春,严力生.现代创伤外科学[M].第2版.北京:科学出版社,2013:411.
[2]徐红平.肾损伤法医学鉴定1例[J].中国法医学杂志,2006(1):62-64.
[3]肖帆,周爱云.输尿管结石合并自发性肾破裂1例[J].中国医学影像技术,2013(12):2019.
[4]谢华杰,李国伟,赵学根,等.重度肾积水感染后肾自发性破裂1例[C]//浙江省科学技术协会.2014浙江省医学会男科学泌尿外科学学术年会论文汇编,2014:272.
[5]吴孟超,吴在德.外科学[M].7版.北京:人民卫生出版社,2008:2301.
[6]吕春燕,时淑燕,杨玲,等.842例肾手术患者临床病理及流行病学研究[J].西部医学,2016(2):208-211.
[7]赵定麟,李增春,严力生.现代创伤外科学[M].第2版.北京:科学出版社,2013:411.