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AAST Kidney injury scale 2018
Grade I
(挫傷, 包膜下血腫, 沒有撕裂傷)
Contusion : Microscopic hematuria or gross hematuria, Urologic studies normal
Hematoma : Subcapsular, nonexpanding without parenchymal laceration
Grade II
Hematoma : Nonexpanding perirenal hematoma confined to renal retroperitoneum
Laceration : < 1 cm parenchymal depth of renal cortex, without urinary extravasation
Grade III
Laceration : > 1 cm parenchymal depth of renal cortex, without collecting system rupture or urinary extravasation
Vascular : Any injury presence of kidney vascular injury or active bleeding contained within Gerota's fascia
** Gerota's fascia 內有 Active bleeding 直接算 Grade III
Grade IV
Laceration : Parenchymal laceration extending through renal cortex, medulla and collecting system with urinary extravasation
Renal pelvis laceration +/- complete UPJ disruption
Vascular : Segmental renal artery or vein injury
Active bleeding beyond Gerota's fascia into retroperitoneum or peritoneum
Segmental or complete renal infarction due to vessel thrombus without active bleeding
** Active bleeding 超出 Gerota's fascia 直接算 Grade III
Grade V
(四分五裂 + 主要血管大傷)
Laceration : Complete shattered kidney with loss of identifiable parenchymal renal anatomy
Vascular : Main renal renal artery or vein laceration or avulsion of hilum
Devascularized kidney with active bleeding
* 血尿的嚴重程度, 和腎臟受傷的程度沒有一定的關聯性
* 治療
- Grade 1~3 非手術治療
- Grade 4：有爭議
- Grade 5 手術治療
* 併發症
血腫, 尿液囊腫(urinoma→可考慮引流掉), 水腎
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