Kidney damage
Needled wrong, hurt the kidneys, “Nei Jing” and also referred to as “Q ban on gill” says: “stabbed in the kidney, the 6th death, and its move to sneeze.” Modern, there are many reports, or because of improper acupuncture, or because of drug acupoint injection caused although some cured by conservative treatment, while others are made nephrectomy bring patients to unnecessary suffering.
[Injury]
Needle-stick injuries generally are the following reasons.
An acupoint reason: substantive kidney paired organs, under normal circumstances, kidneys in the abdominal cavity behind the peritoneum, located on both sides of the spine, the upper pole of the equivalent of 11 or 12 thoracic vertebrae, lower pole in section 2 or section three lumbar plane, right kidney lower than the left kidney of about 1 ~ 2cm. Average length of male adult kidney 11.5cm, width 5.5cm, thickness 3 ~ 4cm, female is slightly smaller than males. In the kidney surface projection area to the left of the 11th thoracic vertebra to the lower edge of the upper bound of the second lumbar lower edge of the lower bound (due to the twelfth rib diagonally over the left kidney Central, so often positioned as a kidney logo). The distance between the two circles after the midline between about 3.5 ~ 10cm range everywhere. Change position of breathing, but not more than one vertebrae. Hidden in the retroperitoneal kidney, abdominal organs covered before, acupuncture is generally impossible to stab it from the abdomen, back acupoints treatment than accidental injury.
Easily lead to kidney damage points as Amba, stomach position, blind doors and Chi room.
May damage the kidneys of the points have stomach Yu, triple burner Yu, Shen Shu, Qi Hai Yu and so on.
In addition, when renal ptosis, then acupuncture Dachangshu, Guan Yuan Yu properly, may cause kidney damage.
Second, the reason for the action: The most common is inappropriate deep puncture. Acupuncture is one of the reasons the wrong direction, the points above may damage the kidneys are located near the kidney surface projection, when outward, or outside on the outer lower deep puncture, the easier stabbed in the kidneys. Secondly, if gentle operation, even if mistakenly, still will not cause greater damage; but way too heavy, or the patient suddenly drastically change posture, severe cough, etc., may increase the gap.
Third, the drugs cause: acupoint injection, when injected drug concentration is too high, too strong irritant, and needle and hit the renal parenchyma, it can damage the kidneys, and even cause necrosis.
Clinical manifestations
Damage due to different degrees of severity of the other symptoms.
One, mild: Department of needlepoint and renal capsule or renal parenchyma only slight superficial stab wounds, partial rupture of small blood vessels. Symptoms are not significant, with only mild kidney pain and urine under a microscope to see the red blood cells.
But some patients, severe damage was obvious symptoms may occur, but often in 2 to 3 weeks after the sudden showing secondary hemorrhage, should be noted.
Second, severe: renal parenchymal rupture or be part of multiple stab wounds. Lower back pain, and often spreads to the shoulders, tenderness, stylish palpable mass, psoas muscle stiffness. The emergence of bleeding more visible haematuria, renal pedicle injuries, bleeding more obvious, excessive bleeding, leading to shock. Kidney rupture, extravasation of urine may, formed around the tumor in the kidney, blood and urine extravasation, leaving increased body temperature due to infection, there may be more severe fever chills, and systemic symptoms of poisoning. Laboratory tests, can be judged according to hematuria decrease renal hemorrhage is progressive or stop severe bleeding, decreased hemoglobin and white blood cell count to rise. X-ray and isotope scans are helpful in diagnosis and determine the degree of injury.
[Prevention]
A master needling depth and direction: in the kidneys of the points within the projection area, such as Chi rooms acupuncture, piercing to no more than 1.5 inches is appropriate. Treatment of lumbar soft tissue injury, should be a 45 ° angle to the spine obliquely, into the needle 2 to 2.5 inches, shenshu other kidney projection area near the inside of the bladder meridian line, obliquely outwards can not be piercing or obliquely to the direction of the spine.
Kidney damage occurred in children, due to a lower position pediatric renal, perirenal fascia hypoplasia. Acupuncture should pay more attention when the depth and direction.
Second, carefully understand feel: When the needle back through the fascia, the resistance suddenly disappeared, and available off the feeling that needle into the kidney capsule has. Touched surfaces such as kidney, thorn in the tape above if men feel, at this time no longer deep puncture.
Three, be careful as point injection: should choose irritation, lower concentrations of the drug, such as the concentration is too high, should be diluted. Withdrawing before pushing drugs look, if blood, should retire after the injection of outside.
Acupuncture points above the patient supine best to prevent postural change. After the needle back pain patients, such as intensified psoas tonic embolism, should be observed for further examination.
[Processing Method]
One, mild: generally heal itself. Should be absolute bed rest for 3 to 4 weeks. Under the circumstances, given analgesic and hemostatic drugs, but also with the use of antibiotics to prevent infection. In the meantime, regular checks of urine, when urine red blood cells completely disappears, yet continue to stay in bed for a week or more.
If damage heavier, more bleeding, is also first with conservative therapy. In the beginning, close observation and treatment, regular blood pressure, pulse, daily erythrocyte count, hemoglobin, hematocrit 1 or 2 times to observe the changes in blood pressure and urinary stop until gross hematuria.
Second, intensive: average to turn surgical surgery. The indications are: injury associated with shock, transfusion, infusion without improvement; obvious gross hematuria, 24 ~ 48h seen significant improvements; perirenal mass continues to increase, there were signs of infection. Surgical suture surgery including kidney, nephrectomy and so on.