URAZY UKŁADU MOCZOWEGO (UROLOGICZNE) - WYTYCZNE EUROPEJSKIEGO TOWARZYSTWA UROLOGICZNEGO (4/4)

<div style="background-color: white; border: 0px; color: #585858; font-family: Helvetica, Arial, sans-serif; font-size: 16px; font-stretch: inherit; line-height: 28px; margin: 0px; padding: 0px; vertical-align: baseline;"> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">4.5.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Organ specyficzne urazy narządów płciowych</span></span></span></h3> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_3_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.3.1.</span></span><span style="margin: 0px; padding: 0px;"> Prącia uraz</span></h4> <h5 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_3_1_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.3.1.1.</span></span><span style="margin: 0px; padding: 0px;"> Blunt uraz prącia</span></h5> <div class="separator" style="border: 0px; clear: both; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; text-align: center; vertical-align: baseline;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTsVV6NJpKsyGEXu5xQgJy78HQhbuSvBPjHgE4mLOEAWtyf8qCYmZvrDBoZvcptviYE1wFzHBgXJkA0vfPkosQKEUx7gbq_EXpFyrnWwK2jmNkD-6RhJRyFPv7d5tAUl-uxlSzHbiwKx8/s1600/a.png" imageanchor="1" style="border: 0px; clear: left; color: #333333; float: left; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 1em 1em 0px; outline: none; padding: 0px; text-decoration: none; transition: all 0.25s; vertical-align: baseline;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTsVV6NJpKsyGEXu5xQgJy78HQhbuSvBPjHgE4mLOEAWtyf8qCYmZvrDBoZvcptviYE1wFzHBgXJkA0vfPkosQKEUx7gbq_EXpFyrnWwK2jmNkD-6RhJRyFPv7d5tAUl-uxlSzHbiwKx8/s200/a.png" style="border: 0px none; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; height: auto; line-height: inherit; margin: 0px; max-width: 100%; outline: none; padding: 0px; position: relative; vertical-align: baseline;" width="115" /></a></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Blunt uraz wiotkiego penisa zazwyczaj nie powoduje łzawienie z osłonki. </span><span style="margin: 0px; padding: 0px;">W takich przypadkach, tylko krwiak podskórny z nienaruszoną osłonki albuginea mogą być postrzegane.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <h6 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_3_1_1_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.3.1.1.1.</span></span><span style="margin: 0px; padding: 0px;"> Prącia złamania</span></h6> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Najważniejszym i wspólna prezentacja tępego urazu prącia jest złamanie prącia. </span><span style="margin: 0px; padding: 0px;">Wynika to z urazem do penisa podczas stosunku płciowego, masturbacja, przewraca się w łóżku (rzadko), a wskutek własnej winy gięcie do produkcji detumescence w niektórych kulturach Bliskiego Wschodu - jest praktyką znaną jako "taqaandan" (co, kiedy przetłumaczone oznacza "kliknięcie") [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_342" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">342</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Najczęstszym mechanizmem urazu jest, gdy penis wsuwa się do pochwy i strajków przeciwko spojenia łonowego lub krocza. </span><span style="margin: 0px; padding: 0px;">Sześćdziesiąt procent przypadków konsensusie wystąpić podczas współżycia [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_343" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">343</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ], i jest bardziej prawdopodobne, gdy partner jest na wierzchu. </span><span style="margin: 0px; padding: 0px;">Prącia pękanie spowodowane pęknięcia jamistych osłonki albuginea, i może być związana z krwiaka podskórnego i zmian w gąbczastego korpusu cewki lub w 10-22% [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_344" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">344</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_345" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">345</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Grubość osłonki białawej w stanie zwisu (około 2 mm), zmniejsza się erekcji odst'pach co 0,25 0,5 mm, a zatem jest bardziej podatna na uszkodzenia urazowego [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_346" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">346</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_347" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">347</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Prącia pękanie jest związane z nagłym pęknięć lub trzaski, ból i natychmiastowe detumescence. </span><span style="margin: 0px; padding: 0px;">Miejscowy obrzęk wału prącia rozwija się szybko, ze względu na powiększenie krwiaka. </span><span style="margin: 0px; padding: 0px;">Krwawienie może rozprzestrzeniać się wzdłuż powięzi warstw penisa i rozciąga się na dolnej ścianie jamy brzusznej, jeśli Powięź Bucka również pękła. </span><span style="margin: 0px; padding: 0px;">Zdarza się, że pęknięcie osłonki może być wyczuwalny. </span><span style="margin: 0px; padding: 0px;">Mniej poważne urazy prącia można odróżnić od złamania prącia, ponieważ nie są one zwykle związane z detumescence.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Gruntowna wywiad i badanie zwykle potwierdzenia diagnozy, ale w niektórych przypadkach może być przydatny do obrazowania. </span><span style="margin: 0px; padding: 0px;">Cavernosography, US lub MRI [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_348-350" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">348-350</span></a><span style="margin: 0px; padding: 0px;"> ] można zidentyfikować rany szarpane na osłonki białawej w niejasnych przypadkach [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_351" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">351</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ] lub dają gwarancję, że tunica jest nienaruszona. </span><span style="margin: 0px; padding: 0px;">Jeśli jednoczesne uszkodzenie cewki moczowej podejrzenia wstecz urethrogram (RUG) mogą być wykonywane, choć elastyczna cystoscopy w znieczuleniu podczas poszukiwań / naprawy jest częściej stosowane.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Krwiaka podskórnego bez związanego przerwania jamistych osłonki albuginea nie wymaga interwencji chirurgicznej. </span><span style="margin: 0px; padding: 0px;">W tych przypadkach, niesteroidowe leki przeciwbólowe i lodu opakowania zaleca się [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_352" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">352</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Kiedy złamanie prącia jest diagnozowana, zalecana jest interwencja chirurgiczna z zamknięcia osłonki białawej.</span><span style="margin: 0px; padding: 0px;">Podejście to zazwyczaj poprzez nacięcia obwodowego proksymalnie od bruzdy czołowej, która umożliwia degloving penisa w całości. </span><span style="margin: 0px; padding: 0px;">Coraz częściej lokalne podłużne nacięcia koncentrujące się na obszarze złamania są obecnie stosowane i dalej lokalizacja może być zdobyte z elastycznym cystoskopii wykonywanej przed nacięciem, jeśli uraz cewki moczowej podejrzenia i ostatecznie udowodnione.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Zamknięcie może być uzyskane przy użyciu wchłanialnych nici z pomyślnym rokowaniem długoterminowym i ochrony mocy. </span><span style="margin: 0px; padding: 0px;">Powikłania pooperacyjne wystąpiły u 9%, w tym powierzchowne zakażenie rany i impotencję u 1,3% [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_343" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">343</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_353" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">353</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Konserwatywny zarządzanie złamania prącia nie jest zalecane. </span><span style="margin: 0px; padding: 0px;">Zwiększa powikłania, takie jak ropień prącia, cewki moczowej, brakowało zakłóceń krzywiznę prącia i uporczywy krwiak wymagający interwencji chirurgicznej opóźnione [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_353" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">353</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Późne powikłania po zachowawczego były zwłóknienie i kątowanie w 35% i impotencję u do 62% [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_343" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">343</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_353" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">353</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_3_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.3.2.</span></span><span style="margin: 0px; padding: 0px;"> Penetrujący uraz prącia</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Penetrujący uraz prącia jest rzadko spotykane w izolacji. </span><span style="margin: 0px; padding: 0px;">W większości przypadków są związane z wieloma urazami.</span><span style="margin: 0px; padding: 0px;">Zarządzanie nieoperacyjnych zalecane jest w małych powierzchownych obrażeń z nienaruszonymi Bucka powięzi [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_262" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">262</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">]. </span><span style="margin: 0px; padding: 0px;">W bardziej znaczące przenikających urazów prącia, zaleca się badanie chirurgiczne i oczyszczenie martwiczej tkanki. </span><span style="margin: 0px; padding: 0px;">Nawet w rozszerzonym urazów prącia, pierwotna wyrównanie rozerwanych tkanek może pozwolić na akceptowalnym uzdrowienia ze względu na solidną dostawę prącia krwi [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_325" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">325</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Zasady opieki są oczyszczenie martwej tkance, z zachowaniem żywych tkankach, jak dużo, jak to możliwe, hemostazy, przekierowania moczu w wybranych przypadkach i usuwania ciał obcych. </span><span style="margin: 0px; padding: 0px;">Tkanki wątpliwej opłacalności może być pozostawiona do późniejszego ostatecznego zabiegu. </span><span style="margin: 0px; padding: 0px;">Jeśli potrzebny jest kolejny remont natychmiastowe lub opóźnione, w zależności od rodzaju urazu i stopnia uszkodzenia tkanki, to odbywa się zwykle od czterech do sześciu tygodni po wystąpieniu trauma.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Podejście chirurgicznego zależy od miejsca i rozległości urazu, ale subcoronal nacięcie z prącia degloving zwykle daje dobrą ekspozycję. </span><span style="margin: 0px; padding: 0px;">Początkowo defekt w błonie białawej powinny zostać zamknięte po nawadniania obfite.</span><span style="margin: 0px; padding: 0px;">Jeśli nastąpiła utrata zbyt dużo tkanki, wada może być naprawione natychmiast lub po opóźnieniu z plastra (albo z autologicznym żyły odpiszczelowej lub heteroprzeszczepu). </span><span style="margin: 0px; padding: 0px;">Jeśli jednoczesne uszkodzenie cewki moczowej podejrzewa, przed- lub peri-operative urethrogram lub cystoscopy jest przydatna do diagnozowania jakiegokolwiek zaangażowania cewki moczowej, aby określić swoje stanowisko i decydować nacięcia używany.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Elastyczność skóry genitaliów oznacza to zwykle możliwe jest zarządzanie strata o umiarkowanej ilości skóry prącia.</span><span style="margin: 0px; padding: 0px;">Jednak zarządzanie jest trudniejsze w rozległych urazów ze znacznym ubytkiem skóry. </span><span style="margin: 0px; padding: 0px;">Tkanka wybrany do odbudowy po urazie musi zapewnić dobre pokrycie i musi być odpowiednia do odbudowy. </span><span style="margin: 0px; padding: 0px;">Split-grubości skóry szczepienia zapewnia dobre pokrycie i niezawodną ujęcie, które jest powtarzalne i trwałe. </span><span style="margin: 0px; padding: 0px;">Jednak podział grubości przeszczepy umowy więcej niż przeszczepy pełnej grubości, a ich stosowanie na wale prącia powinny być ograniczone do minimum.</span><span style="margin: 0px; padding: 0px;">Zgodnie, McAninch  </span></span><span class="bodytekstitalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">wsp.</span></span><span style="margin: 0px; padding: 0px;"> Zaleca się stosowanie przeszczepów skóry o grubości wynoszącej co najmniej 0,015 cala (0,4 mm) w celu zmniejszenia ryzyka wystąpienia skurczu [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_325" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">325</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Pełnej grubości skóry szczepienie na penisa daje mniej przykurcz, lepszy wygląd estetyczny i większą odporność na uraz podczas stosunku, kiedy w końcu przywrócona [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_352" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">352</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">]. </span><span style="margin: 0px; padding: 0px;">Witryna dawcy mogą być pobrane z brzucha, pośladków, ud lub pachy i został dobrany w zależności od preferencji chirurga i wzór szkody.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">W przypadku dużej ilości zniszczenia głębszych tkanek, czy później protezy umieszczenie jest uważane, płaty skóry z ich bezpiecznego dostarczania naczyń, mogą być użyte.</span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_3_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.3.3.</span></span><span style="margin: 0px; padding: 0px;"> Prącia urazy avulsion i amputacji</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Większość urazów są samookaleczenia, ale niektóre są wynikiem wypadków przemysłowych lub ataku. </span><span style="margin: 0px; padding: 0px;">Ostra zarządzania obejmuje reanimacji pacjenta, który może być zagrożona z masywnej utraty krwi i przygotowania do ponownego chirurgicznej implantacji prącia, jeżeli zostało odzyskane i nie jest zbyt mocno uszkodzony. </span><span style="margin: 0px; padding: 0px;">Chirurgiczne ponowne wszczepienie należy rozważyć dla wszystkich pacjentów, należy przeprowadzić w ciągu 24 godzin po amputacji. </span><span style="margin: 0px; padding: 0px;">Jeżeli uszkodzenie nastąpiło w czasie epizodu psychotycznego, wczesne doradztwo psychiatryczne i wsparcie powinny być poszukiwane.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Odcięty penis powinna być prana w jałowej soli fizjologicznej, soli fizjologicznej w zawinięte nasączone gazą, umieszczono w sterylnym worku i zanurzano w lodowatej wodzie. </span><span style="margin: 0px; padding: 0px;">Penis nie może mieć bezpośredniego kontaktu z lodem. </span><span style="margin: 0px; padding: 0px;">Opatrunek ciśnienia lub opaski powinny być umieszczone wokół kikuta prącia, aby zapobiec nadmiernej utracie krwi. </span><span style="margin: 0px; padding: 0px;">Ponownie mocowania mogą być osiągnięte w sposób non-mikrochirurgiczne, technikę, która prawdopodobnie daje wyższe stopy pooperacyjnego zwężenia cewki moczowej i więcej problemów z utratą czucia [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_354" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">354</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Podczas pracy pod mikroskopem, ciał jamistych i cewki moczowej są najpierw wyrównane i naprawiane. </span><span style="margin: 0px; padding: 0px;">Następnie tętnice grzbietowej prącia, żyła grzbietowa i grzbietowych nerwów zespolona. </span><span style="margin: 0px; padding: 0px;">Tętnice jamistych są zazwyczaj zbyt małe, aby anastomose.</span><span style="margin: 0px; padding: 0px;">Powięzi i skóry są zamknięte w warstwach i zarówno cewki moczowej i cewnik supra-łonowe są umieszczone.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Jeśli przecięte penisa nie może być znaleziony, albo nie nadaje się do ponownego zamocowania, wówczas końcowy powinien być zamknięty, jak to odbywa się w częściowym penektomia. </span><span style="margin: 0px; padding: 0px;">Później przebudowy mogą być stosowane do wydłużania penisa (np zawieszający podział więzadła i VY plastyka, tworzenie pseudo-żołędzi z dzielonym grubości skóry szczepienia, itp). </span><span style="margin: 0px; padding: 0px;">Opóźniona główną procedurę rekonstrukcyjnej, tj prącia (albo tętnicy promieniowej lub łonowe), jest czasami niezbędne do urazów, które pozostawiają niewiele lub ustania działania prącia pniu.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="4_5_4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">4.5.4.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Moszny trauma</span></span></span></h3> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_4_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.4.1.</span></span><span style="margin: 0px; padding: 0px;"> Blunt uraz moszny</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Blunt uraz moszny może spowodować przemieszczenie jąder, jąder, jąder haematocoele pęknięcia i / lub krwiak moszny.</span></div> <h5 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_4_1_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.4.1.1.</span></span><span style="margin: 0px; padding: 0px;"> Jąder dyslokacji</span></h5> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Urazowe zwichnięcie jądra występuje rzadko. </span><span style="margin: 0px; padding: 0px;">Jest to najczęściej u ofiar MVAs [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_355-358" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">355-358</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Obustronne zwichnięcie jąder odnotowano w wysokości do 25% przypadków [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_356" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">356</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Może to być albo podskórnie przemieszczenie z epifascial przemieszczenia jądra lub wewnętrznego dyslokacji. </span><span style="margin: 0px; padding: 0px;">W tym drugim przypadku, jest umieszczony w jądrach powierzchniowej zewnętrznej pierścienia pachwinie, kanał lub jamy brzusznej. </span><span style="margin: 0px; padding: 0px;">Urazowe zwichnięcie jądrach jest traktowany przez ręcznej wymiany i wtórnym orchidopeksja. </span><span style="margin: 0px; padding: 0px;">Jeśli podstawowa instrukcja repozycji nie może być wykonana, wskazana jest natychmiastowa orchidopeksja.</span></span></div> <h5 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_4_1_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.4.1.2.</span></span><span style="margin: 0px; padding: 0px;"> Haematocoele</span></h5> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zachowawcze zaleca się haematoceles mniejszych niż trzykrotność wielkości jąder przeciwnej [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_359" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">359</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">W dużych haematoceles, zarządzanie nieoperacyjne często kończy się niepowodzeniem i opóźnionej operacji (> trzy dni) jest często wymagane. </span><span style="margin: 0px; padding: 0px;">Pacjenci z dużymi haematoceles mają wyższą stopę orchiektomii niż u pacjentów, którzy przechodzą operację wcześnie, nawet w non-pękniętych jąder [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_317" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">317</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_325" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">325</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_360-362" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">360-362</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Wczesne wyniki interwencji chirurgicznych w ochrony jąder u ponad 90% pacjentów w stosunku do opóźnionej operacji, które powodują orchidektomii na 45-55% pacjentów [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_362" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">362</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Ponadto, zarządzanie nieoperacyjne jest również związany z wydłużeniem hospitalizacji. </span><span style="margin: 0px; padding: 0px;">W związku z tym, duże haematoceles należy traktować chirurgicznym bez względu na obecność jądra stłuczenia lub pęknięcia. </span><span style="margin: 0px; padding: 0px;">Przynajmniej, skrzep krwi powinny być ewakuowane z osłonki pochwowej worka do łagodzenia niepełnosprawności i przyspieszyć powrót do zdrowia. </span><span style="margin: 0px; padding: 0px;">Pacjenci początkowo traktowane nieoperacyjnie z koniecznością operacji opóźnione w przypadku wystąpienia infekcji lub niepotrzebnego bólu.</span></span></div> <h5 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_4_1_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.4.1.3.</span></span><span style="margin: 0px; padding: 0px;"> Jąder pęknięcie</span></h5> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Jąder pęknięcie występuje w około 50% przypadków bezpośredniego tępym urazie moszny [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_362" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">362</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Może to wystąpić przy intensywnym urazowego ściskania jąder z dolnego lub spojenia łonowego ramus, powodując pęknięcia osłonki białawej jądra. </span><span style="margin: 0px; padding: 0px;">Siła około 50 kg, jest więc konieczne, aby spowodować pęknięcie jąder [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_363" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">363</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jąder pęknięcie jest związane z bezpośrednim bólu, nudności, wymioty, a czasami omdlenia. </span><span style="margin: 0px; padding: 0px;">Hemiscrotum zmięknie, obrzęk i wylewy.</span><span style="margin: 0px; padding: 0px;">Samo jądro może być trudne dotknąć.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">O wysokiej rozdzielczości w czasie rzeczywistym US z sondą wysokiej rozdzielczości (minimum 7,5 MHz lub wyższy) powinny być wykonywane w celu określenia wewnątrz- i / lub wyjątkowo jąder krwiak jąder kontuzji lub zerwanie [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_364-371" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">364-371</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">W literaturze są sprzeczne co ​​do przydatności USA w stosunku do samego badania klinicznego. </span><span style="margin: 0px; padding: 0px;">Niektóre badania wykazały przekonujących wniosków o swoistości do 98,6% [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_347" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">347</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Inne zgłaszane słabą specyficzność (78%) i czułość (28%) dla różnicowania między jąder pęknięcia i haematocele, a dokładność jest tak niskie, jak 56% [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_365" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">365</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Kolor Doppler duplex mogą US dostarczyć użytecznych informacji, gdy wykorzystane do oceny perfuzji jąder. </span><span style="margin: 0px; padding: 0px;">Jeśli moszny USA jest niejednoznaczny, jąder CT lub MRI może być pomocne [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_372" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">372</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jednakże, techniki te nie specjalnie zwiększać współczynniki wykrywania jąder pęknięciem. </span><span style="margin: 0px; padding: 0px;">Dlatego istotne jest, aby zbadać pacjentów chirurgicznie niejednoznacznych gdy badaniach obrazowych nie można definitywnie wykluczyć pęknięcie jąder. </span><span style="margin: 0px; padding: 0px;">Wiąże się to z eksploracji ewakuacji skrzepy krwi i krwiak, wycięciu wszelkich martwiczych kanalików jąder i zamknięcia osłonki białawej, zazwyczaj z systemem wchłanialnych szwów (np 3/0 Vicryl).</span></span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_4_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.4.2.</span></span><span style="margin: 0px; padding: 0px;"> Penetrujący uraz moszny</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Penetrujące urazy do moszny wymagają eksploracji chirurgicznej z konserwatywnej oczyszczenie nieżywotnego tkanki.</span><span style="margin: 0px; padding: 0px;">W zależności od stopnia uszkodzenia, pierwotne rekonstrukcja jądrach oraz mosznie może zwykle być przeprowadzane. </span><span style="margin: 0px; padding: 0px;">W kompletnej zakłócenia powrózka nasiennego, przebudowa bez zatorów vasostomy mogą być uznane, jeżeli chirurgicznie wykonalne [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_373" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">373</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Stopniowe wtórne mikrochirurgiczne zwężające naczynia vasostomy można przeprowadzić po rehabilitacji, choć tylko kilka przypadków odnotowano [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_373" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">373</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jeśli nie jest rozległe zniszczenie osłonki białawej mobilizacja wolnego osłonki vaginalis klapki mogą być wykonane dla jąder zamknięcia. </span><span style="margin: 0px; padding: 0px;">Jeżeli pacjent jest niestabilny lub przebudowy nie mogą być osiągnięte, wycięcie jądra jest informacja.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Profilaktyczne antybiotyki są zalecane po moszny penetrujący uraz, chociaż dane na poparcie tego podejścia brakuje.</span><span style="margin: 0px; padding: 0px;">Tężec profilaktyka jest obowiązkowe. </span><span style="margin: 0px; padding: 0px;">Powikłania pooperacyjne wystąpiły u 8% pacjentów, którzy przeszli jąder naprawy po penetrujący uraz [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_262" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">262</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Rozszerzony rana w skórze moszny wymaga interwencji chirurgicznej w celu zamknięcia skóry. </span><span style="margin: 0px; padding: 0px;">Ze względu na elastyczność moszny, większość wady mogą być przede wszystkim zamknięte, nawet jeśli lacerated skóra jest tylko minimalnie dołączony do moszny [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_325" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">325</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Lokalne zarządzanie rany z dużym wstępnym oczyszczeniu rany i wymywania jest ważne dla moszny rekonwalescencji. </span><span style="margin: 0px; padding: 0px;">W przypadku rozległej utraty tkanki narządów, np IED kontuzji wielkopiecowy, złożonym i reżyserowane rekonstrukcyjnej zabiegi chirurgiczne są często wymagane [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_323" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">323</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="4_5_5" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">4.5.5.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Urazami narządów płciowych u kobiet</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">U kobiet z tępym urazem zewnętrznych narządów płciowych, obrazowanie miednicy z nami, CT lub MRI, należy wykonać od dodatkowych urazów i rozległych krwiaków wewnątrzwspólnotowych miednicy są często oczekiwano [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_329" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">329</span></a><span style="margin: 0px; padding: 0px;">, </span><a href="https://uroweb.org/guideline/urological-trauma/#note_339" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">339</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4_5_5_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">4.5.5.1.</span></span><span style="margin: 0px; padding: 0px;"> Tępe urazy sromu</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Blunt uraz sromu jest rzadko i zazwyczaj prezentuje jak duży krwiak. </span><span style="margin: 0px; padding: 0px;">Częstość występowania krwiaków pourazowych sromu po dostaw pochwy została zgłoszona jako jeden w 310 dostawach [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_374" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">374</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Mimo, że tępy uraz żeńskich narządów płciowych zewnętrznego rzadko, obecność sromu krwiaka ściśle wiąże się ze zwiększonym ryzykiem wystąpienia pochwy miednicy lub urazami jamy brzusznej. </span><span style="margin: 0px; padding: 0px;">Goldman  </span></span><span class="bodytekstitalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">i wsp.</span></span><span style="margin: 0px; padding: 0px;">  Podano, że urazy tępe sromu i pochwy były związane z urazem miednicy w 30%, w stosunku konsensualnej w 25%, po seksualnego w 20%, a inne tępym narzędziem w 15% [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_328" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">328</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Tępe sromu lub krocza może wiązać się z problemami mikcji i zazwyczaj wymaga cewnikowania pęcherza moczowego. </span><span style="margin: 0px; padding: 0px;">Krwiaki sromu zazwyczaj nie wymagają interwencji chirurgicznej, choć mogą powodować znaczną utratę krwi, co niekiedy wymaga transfuzji krwi. </span><span style="margin: 0px; padding: 0px;">Dane są rzadkością [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_375" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">375</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ], ale w stabilnych hemodynamicznie kobiet, niesteroidowe leki przeciwzapalne i zimne opakowania są zazwyczaj skuteczne. </span><span style="margin: 0px; padding: 0px;">Jednak w przypadkach masywnego krwiaka sromu i pacjentów niestabilnych hemodynamicznie, interwencja chirurgiczna płukanie i drenaż jest czasami wskazana [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_376" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">376</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Chociaż antybiotyki są często zalecane po poważnych urazach sromu, nie ma żadnych danych na poparcie tego podejścia. </span><span style="margin: 0px; padding: 0px;">Ważne jest, aby podkreślić, że krwiak sromu i / lub krew w pochwy Introitus są wskazania do pochwy eksploracji pod sedacji lub znieczulenia ogólnego. </span><span style="margin: 0px; padding: 0px;">Celem jest identyfikacja możliwego powiązanych pochwy i / lub odbytnicy obrażeń [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_329" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">329</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Elastyczne lub sztywne cystoscopy został rekomendowany do wykluczenia z cewki moczowej i pęcherza obrażeń [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_328" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">328</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_329" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">329</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">W przypadku sromu uszkodzenia, wskazane jest szycie zachowawczo oczyszczeniu. </span><span style="margin: 0px; padding: 0px;">Jeżeli nie są związane do urazów pochwy, można naprawić natychmiast podstawowej szwów.</span></span></div> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="4_5_6" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">4.5.6.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Podsumowanie dowodów i zaleceń w zakresie zarządzania urazami narządów płciowych</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Większość narządów urazy, u mężczyzn i kobiet, są spowodowane tępym urazem.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> 3</div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">W złamania prącia, traktować początku leczenia chirurgicznego, z zamknięcia osłonki albuginea, aby umożliwić dobry wynik długoterminowego i zachowanie potencji.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">W jąder traumy, należy wykonać badanie chirurgiczne we wszystkich przypadkach pęknięcia i jąder u pacjentów z niejednoznacznym obrazowania.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> </tbody></table> </div> <div style="background-color: white; border: 0px; color: #585858; font-family: Helvetica, Arial, sans-serif; font-size: 16px; font-stretch: inherit; line-height: 28px; margin: 0px; padding: 0px; vertical-align: baseline;"> <h1 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 30px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 30px; margin: 0px 0px 20px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.</span></span><span style="margin: 0px; padding: 0px;"> urazie, Damage Control I MASS Casualty IMPREZY</span></h1> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Wprowadzenie</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Urologiczny urazy często wiąże się ze znacznymi i większych obrażeń priorytetowych w polytraumatised pacjenta [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_377" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">377</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">]. </span><span style="margin: 0px; padding: 0px;">Lekcje z cywilnych sieciach uraz, bitwy i wydarzenia masa nieszczęśliwych wypadków doprowadziły do wielu osiągnięć w opiekę ogólną traumy [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_378" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">378</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_379" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">379</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Obejmują one szeroką akceptację zasad kontroli uszkodzeń, uraz centralizacji i uznawania wartości dedykowanych zespołów urazowych. </span><span style="margin: 0px; padding: 0px;">Urolodzy muszą zrozumieć ich rolę w kontekście urazie z ostatecznych celów poprawy przeżywalności i zmniejszenia zachorowalności u tych pacjentów.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_1_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.1.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Rozwój dużych centrów urazowych</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Multidyscyplinarna Leczenie pacjentów urazowych wykazano poprawę wyników [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_380" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">380</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Główne pacjentów urazowych początkowo zarządzanych szpitali są od 1,5 do 5 razy bardziej narażone na śmierć niż u pacjentów transportowanych bezpośrednio do specjalistycznych ośrodków urazowych. </span><span style="margin: 0px; padding: 0px;">Reorganizacja starannością tych ośrodków wykazano zmniejszenie śmiertelności o 25% i długości pobytu przez cztery dni [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_378" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">378</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span class="" style="margin: 0px; padding: 0px;">Główne centra urazowe, które są oczekiwane w celu zapewnienia wyższego kierował zespołami resuscytacji uraz, dedykowane teatry uraz, wejście od wszystkich głównych specjalności chirurgicznych i interwencyjnych radiologów, zostały zatem ustalone na całym świecie. </span><span style="margin: 0px; padding: 0px;">Urolodzy mają ważną rolę do odegrania w tym procesie [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_381" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">381</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="kop4_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_1_1_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.1.1.1.</span></span><span style="margin: 0px; padding: 0px;"> Zalecenia dotyczące zarządzania urazie</span></div> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zalecenie</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zarządzaj pacjentów urazie w wyznaczonych głównych centrów urazowych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA*</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Upewnić zaangażowania urologów w przypadkach towarzyszącym urologicznej kontuzji.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA*</span></div> </td></tr> </tbody></table> <div class="bodytekst_italic_onder_tabel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -15px 0px 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">* Ulepszony po panelu konsensusu.</span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Kontrola Obrażenia</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Damage Control to strategia ratowania życia u pacjentów z poważnymi urazami, które rozpoznaje konsekwencje śmiertelną triadą urazu, tj hipotermii, koagulopatii i kwasicy [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_382-384" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">382-384</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_geen_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -20px 0px 20px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Jest to priorytetowe podejście trójfazowe:</span></div> <ul style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; list-style-position: outside; margin: 0px 0px 20px; outline: 0px; padding: 0px 18px; vertical-align: baseline;"> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Pierwszy etap polega na szybkiej kontroli krwotoku i zanieczyszczenia rany,</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Drugi etap polega na reanimacji na oddziale intensywnej opieki medycznej (OIOM), w celu przywrócenia normalnej temperatury, koagulacji i dotlenienie tkanek,</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Trzeci etap polega na ostateczną operację, gdy więcej zabiegów rekonstrukcyjnych czasochłonne są wykonywane w stabilizowanej pacjenta [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_385" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">385</span></a><span style="margin: 0px; padding: 0px;"> ].</span></li> </ul> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Identyfikowanie którym pacjenci skorzystają z trybu kontroli uszkodzeń wymaga krytycznej podejmowania decyzji przez lidera zespołu uraz. </span><span style="margin: 0px; padding: 0px;">Przed gotowość i regularna komunikacja między chirurgicznych, intensywnej opieki i znieczulających zespoły są niezbędne [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_386" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">386</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Zasady kontroli uszkodzeń zostały pomyślnie przyjęte w kontekście cywilnych imprez masowych katastrof, wojskowej Chirurgia i wstępnej obróbki na obszarach wiejskich z transferów dalekiego zasięgu [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_383" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">383</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_387" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">387</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zasady zarządzania: wielokrotny uraz i uszkodzenie Associated urologiczne</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Urolodzy często proszony o radę u pacjentów urazie, z których niektóre mogą być w fazie kontroli uszkodzeń zarządzania. </span><span style="margin: 0px; padding: 0px;">Na szczęście, zarządzanie urologicznej traumy często wiąże się z wykorzystaniem środków tymczasowych, a następnie później ostatecznego zabiegu, który zmieści się w dobrze z tymi zasadami.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">W ustawieniu urazie, urolog zazwyczaj pracują obok ogólnej chirurga urazowego /. </span><span style="margin: 0px; padding: 0px;">Procedury powinny być skierowane do szybkiego opanowania krwawienia, oczyszczenie tkanki martwej i martwej, a minimalizując moczu wynaczynienia prostymi środkami dywersyjnych. </span><span style="margin: 0px; padding: 0px;">Skomplikowane procedury rekonstrukcyjne, w tym zachowania narządu, korzystnie są opóźnione.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Przykłady, w których wymagane jest wejście urologiczne w polytraumatised pacjenta obejmują:</span></div> <ul style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; list-style-position: outside; margin: 0px 0px 20px; outline: 0px; padding: 0px 18px; vertical-align: baseline;"> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">pacjentów niestabilnych hemodynamicznie z podejrzeniem krwawienia w obrębie jamy brzusznej, które przekazywane są niezwłocznie do sali operacyjnej bez obrazowania przedoperacyjnego;</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Stabilne pacjentów z podejrzeniem nerek urazy penetrujące urazy nadbrzuszu / boki / dolnej części klatki piersiowej lub tępego urazu brzucha i widoczną krwiomocz;</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Pacjenci z podejrzeniem urazu cewki moczowej lub pęcherza moczowego związanego ze złamaniami miednicy; </span><span style="margin: 0px; padding: 0px;">krwi u ujścia cewki moczowej i / lub niemożności nieważna;</span></span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Zewnętrzne narządy płciowe uraz związany z penetrujący uraz (uszkodzenie w obrębie jamy brzusznej).</span></li> </ul> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_3_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.3.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Podsumowanie dowodów i zaleceń dotyczących zasad zarządzania urazie i powiązane uraz urologiczne</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zasady kontroli uszkodzeń regulują zarządzanie poważnie rannych urazie pacjenta.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> 4</div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zalecenie</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Postępuj zgodnie z zasadami kontroli uszkodzeń w leczeniu pacjentów z ciężką urazie.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA*</span></div> </td></tr> </tbody></table> <div class="bodytekst_italic_onder_tabel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -15px 0px 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">* Ulepszony po panelu konsensusu.</span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Urologiczny zarządzania szkody w urazie</span></span></span></h2> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Nerkowy uraz</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Częstość występowania wielonarządowej szkody jest wysoko w penetrujący uraz [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_31" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">31</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Większość z tych urazów można zarządzać bez eksploracji chirurgicznej [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_28" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">28</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Niewydolność eksploracji jest zobowiązany do kontrolowania zagrażające życiu krwawienia [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_388" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">388</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Zachowanie realnej miąższu nerek jest drugim celem, o czasochłonnej odbudowy nerek opóźnione dopóki pacjent jest zoptymalizowany [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_111" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">111</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Przy laparotomii, uważa się, najlepiej jest nie zbadania uszkodzonej nerek jeśli nie ma aktywnego krwotok, nawet jeśli opóźnione poszukiwań jest to konieczne, [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_78" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">78</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">U chorych niestabilnych, pakowanie fossa nerek i przenoszenia pacjenta na oddziale intensywnej terapii chirurgicznej jest możliwość wyboru do kontroli uszkodzeń. </span><span style="margin: 0px; padding: 0px;">Planowane laparotomii drugiego wygląd jest następnie wykonywana [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_182" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">182</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jednakże u pacjentów ze znacznym trwającej krwotoku, wymagana jest szybka nefrektomia. </span><span style="margin: 0px; padding: 0px;">Zaleca przeciwnej nerek powinny być co najmniej wyczuwalne przed nefrektomii [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_389" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">389</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">U pacjentów, którzy są pakowane czasowo, którzy stają się wystarczająco stabilny w intensywnej, ocena radiologiczna umożliwia ostateczne zarządzanie zacząć. </span><span style="margin: 0px; padding: 0px;">Tomografia komputerowa pozwala na uraz nerki być stopniowane, dokumentuje obecność przeciwnej nerek i pomaga określić, czy interwencja (radiologicznej lub chirurgicznej) jest konieczne.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">U pacjentów, którzy są niestabilne hemodynamicznie po początkowej, ostrej uszkodzenia sterowania, laparotomii, lub u pacjentów z pogarszającą parametrów hemodynamicznych (wskazujące na bieżące lub opóźnione krwawienie), opcje zarządzania są angiograficzne embolizacji nerek krwawienia lub ponownej operacji. </span><span style="margin: 0px; padding: 0px;">Decyzja ta powinna być wykonana zgodnie z:</span></span></div> <ul style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; list-style-position: outside; margin: 0px 0px 20px; outline: 0px; padding: 0px 18px; vertical-align: baseline;"> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Stan pacjenta;</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Obecność związanych urazów (zszyte jelit, pakowane wątroby lub śledziony), które mogą wymagać ponownej operacji niezależnie od urazu nerek;</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Dostępność angioembolisation.</span></li> </ul> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_4_1_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.4.1.1.</span></span><span style="margin: 0px; padding: 0px;"> Zachowanie Niewydolność</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">hemostatyczne techniki, z których wiele zostało opracowane dla chirurgii wątroby i śledziony urazu, mogą być używane do sterowania miąższu nerek, krwawienie. </span><span style="margin: 0px; padding: 0px;">Techniki te nie są zgodne z zasadami kontroli uszkodzeń i powinny być rozważane jedynie w rzadkich sytuacji ofiarą jedynej nerki lub dwustronnej uszkodzenia nerek.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Techniki te są przedstawione poniżej:</span></div> <ul style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; list-style-position: outside; margin: 0px 0px 20px; outline: 0px; padding: 0px 18px; vertical-align: baseline;"> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Szwy Materac poprzez miąższu, tj renorrhaphy [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_182" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">182</span></a><span style="margin: 0px; padding: 0px;"> ].</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Środki hemostatyczne, czyli połączone bezkomórkowe matryce i fibryny uszczelniacze [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_113" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">113</span></a><span style="margin: 0px; padding: 0px;"> ].</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Worki wchłanialne nerki siatka utrzymania kontaktu pomiędzy fragmentów miąższu nerek [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_106" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">106</span></a><span style="margin: 0px; padding: 0px;"> ].</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Śródoperacyjnej spustowy pozostaje  </span><span class="bodytekstitalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">na miejscu</span></span><span style="margin: 0px; padding: 0px;">  , aby zbierać wszelkie moczu, które wycieka następujących narządów ratowniczych.</span></li> </ul> <div class="kop4_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_4_1_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.4.1.2.</span></span><span style="margin: 0px; padding: 0px;"> Zalecenia dotyczące postępowania w przypadku uszkodzenia nerek</span></div> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zarządzaj zagrażające życiu krwawienia z uszkodzenia nerek przez pilne nefrektomii.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zarządzaj obfite krwawienie tętnicze bez opakowania przez nerki jako środka kontroli uszkodzeń.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Użyj angioembolisation jako skuteczny środek hemostazy.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> </tbody></table> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Uszkodzenie moczowodu</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Urazy moczowodów są związane przede wszystkim z penetrujący uraz jamy brzusznej; </span><span style="margin: 0px; padding: 0px;">mimo szybkiego zwalniania urazy mogą powodować zakłócenia ureteropelvic [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_165" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">165</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Wysoki wskaźnik podejrzeń jest wymagane, ponieważ te urazy są dość powszechnie brakowało [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_390" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">390</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Wyniki bezpośrednim moczowodu rekonstrukcji są ogólnie zadawalające, ale jest to czasochłonne i może nie być odpowiedni w polytraumatised pacjenta. </span><span style="margin: 0px; padding: 0px;">Procedury diagnostyczne, takie jak IVP on-tabeli lub wsteczny ureteropyelography oceny urazów moczowodów Nie zaleca się również w tym ustawieniu.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Jeżeli uszkodzenie moczowodu jest podejrzany, ale nie jasno określone, drenaż powinien być zlokalizowany. </span><span style="margin: 0px; padding: 0px;">Jeśli mocz wycieka po operacji, o nefrostomii powinny być ustawione. </span><span style="margin: 0px; padding: 0px;">Jeśli częściowy moczowodów łza jest identyfikowany (mniej niż pół obwód) i moczowód jest inaczej zdrowy, podwójne J-stent może być włożony nad drutem prowadzącym przez łzy, a łza szybko zamknął z drobnymi przerwami wchłanialnych szwów.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Gdy kompletne Urazy moczowodów są identyfikowane, ostateczne naprawa nie powinna być wykonywana. </span><span style="margin: 0px; padding: 0px;">Rozbiór kikutów moczowodu należy unikać, gdyż zakłóca dopływ krwi. </span><span style="margin: 0px; padding: 0px;">środki tymczasowe w celu kontrolowania wycieku moczu należy wykonać:</span></span></div> <ul style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; list-style-position: outside; margin: 0px 0px 20px; outline: 0px; padding: 0px 18px; vertical-align: baseline;"> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Pojedynczy francuski otwór wlotowy J lub 8 jest włożony do moczowodu;</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Koniec bliższy zakłóconego moczowód jest zamocowany na rurze, która jest exteriorised i mocowana do skóry.</span></li> </ul> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Dalszy moczowodu pnia nie musi być łączona i powinno się unikać zbędnego manipulacji. </span><span style="margin: 0px; padding: 0px;">Umieszczenie śródoperacyjnej rurki nefrostomii jest czasochłonne i należy unikać [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_111" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">111</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_182" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">182</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wiązanie się rannego odcinka moczowodu i wstawienie przezskórnej nefrostomii pooperacyjnym jest realną alternatywą [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_391" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">391</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Rzadko w przypadkach związanych z ciężkimi urazami po tej samej stronie nerki, nefrektomia jest wymagane.</span></span></div> <div class="kop4_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_4_2_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.4.2.1.</span></span><span style="margin: 0px; padding: 0px;"> Zalecenia dotyczące postępowania w przypadku uszkodzenia moczowodu</span></div> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wykluczyć uraz moczowodu w penetrujący uraz jamy brzusznej.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Traktować obrażeń moczowodów z "rury" moczu, jeśli naprawa nie zostanie wykonana.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> </tbody></table> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Pęcherz trauma</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">W ostrej ustawienia urazie, uszkodzenia pęcherza powinny być traktowane z drenażem pęcherza przez nadłonowy i / lub cewnik w cewce moczowej. </span><span style="margin: 0px; padding: 0px;">Później ostateczne leczenie może postępować w razie potrzeby [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_190" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">190</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Idealnie, duże dootrzewnowo pęknięcia pęcherza (często związane z niestabilnych złamań miednicy) powinny być zamknięte, a przede wszystkim po odsączeniu, jak to będzie poradzić sobie z kontrolą zarówno krwawienia i zanieczyszczenia moczu.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Przykłady tymczasowych środków, które mogą okazać się niezbędne są:</span></div> <ul style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; list-style-position: outside; margin: 0px 0px 20px; outline: 0px; padding: 0px 18px; vertical-align: baseline;"> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Umieszczenie Zlecanie stentów moczowodu w celu zapewnienia zewnętrznego drenażu pęcherza moczowego u rozległej pęknięcia [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_182" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">182</span></a><span style="margin: 0px; padding: 0px;"> ];</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Pakowania i / lub arteriografię i selektywnej embolizacji u chorych niestabilnych z ciężkim krwotoku pęcherza [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_182" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">182</span></a><span style="margin: 0px; padding: 0px;"> ];</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Umieszczenie w miednicy drenażu ssącego do ewakuacji moczu [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_182" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">182</span></a><span style="margin: 0px; padding: 0px;"> ].</span></li> </ul> <div class="kop4_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_4_3_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.4.3.1.</span></span><span style="margin: 0px; padding: 0px;"> Zalecenia dotyczące postępowania w przypadku urazu pęcherza</span></div> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zapewnić odpływ moczu albo przez ponad spojeniem łonowym lub cewki moczowej trasie.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zapewnienie środków tymczasowych "kontrola szkody" w skomplikowanych urazów pęcherza w otoczeniu urazie.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> </tbody></table> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.4.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Uszkodzenie cewki moczowej</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Uraz cewki moczowej jakiegokolwiek rodzaju nie zagraża życiu, ale związane z nimi urazy są często ciężkie. </span><span style="margin: 0px; padding: 0px;">W tej sytuacji, gdzie lokalizacja lub rozmiarów szkody, drenaż przez ponad spojeniem łonowym lub cewki moczowej cewnika powinna być uzyskana bez uprzedniej obrazowania [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_256" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">256</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="kop4_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_4_4_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.4.4.1.</span></span><span style="margin: 0px; padding: 0px;"> Zalecenie dla zarządzania uszkodzenia cewki moczowej</span></div> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zalecenie</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zapewnienie pilne odpływ moczu albo przez ponad spojeniem łonowym lub cewki moczowej trasie.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> </tbody></table> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_5" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.5.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zewnętrzne uszkodzenie narządów</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Tradycyjnie, traumatyczne urazy zewnętrznych narządów płciowych mają niski priorytet i zarządzanie jest często odraczane [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_392" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">392</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">W polytraumatised pacjenta, zarządzanie tymi urazami należy kierować się zasadami kontroli krwawienia, oczyszczenie i dywersji moczowych (poprzez cewnik). </span><span style="margin: 0px; padding: 0px;">Opóźniona ochrona narządów jest możliwe, zwłaszcza jąder urazu [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_393" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">393</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Tymczasowe środki kontroli uszkodzeń, które mogą być stosowane obejmują:</span></div> <ul style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; list-style-position: outside; margin: 0px 0px 20px; outline: 0px; padding: 0px 18px; vertical-align: baseline;"> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Opatrunek Kompresja penisa [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_182" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">182</span></a><span style="margin: 0px; padding: 0px;"> ];</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Pakowanie penetrujące urazy jąder;</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Tampony dla sromu ran.</span></li> </ul> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_5" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.5.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Masowe imprezy wypadków</span></span></span></h2> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zdarzenie wypadku masa jest taka, w której liczba rannych jest znacznie większa niż liczba dostępnych dostawców zdrowia [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_394" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">394</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Masowy wypadek katastrofy nie ma zatem konieczności angażowania dużej liczby ofiar, ale jest to związane z dysproporcji pomiędzy liczbą ofiar i wielkości zespołu medycznego dostępnego [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_395" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">395</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_396" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">396</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Istnieje niewiele opublikowanych danych na temat najlepszego sposobu, w jaki do obsługi tych zdarzeń.</span><span style="margin: 0px; padding: 0px;">Jednakże ostatnie zmiany w ustawieniach zarówno wojskowych i cywilnych doprowadziły do zwiększenia przeżywalności po poważnych urazach [ </span></span><a href="https://uroweb.org/guideline/urological-trauma/#note_397" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">397</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Triage, komunikacja i gotowość są ważnymi składnikami dla pomyślnej odpowiedzi.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Potencjalne imprez masowych wypadków należą:</span></div> <ul style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; list-style-position: outside; margin: 0px 0px 20px; outline: 0px; padding: 0px 18px; vertical-align: baseline;"> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">wypadki systemów transportowych, np ruchu drogowego, samoloty, żegluga, koleje;</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Klęski żywiołowe, np trzęsienia ziemi, huragany, powodzie, tsunami;</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Przemysł, np wycieki chemiczne, wybuchy i pożary fabryk;</span></li> <li style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 60px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Cywilny terroryzm.</span></li> </ul> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_5_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.5.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Triage</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Triage po masowych imprez nieszczęśliwych wypadków jest trudna i wymaga trudnych względy moralne i etyczne.</span><span style="margin: 0px; padding: 0px;">Katastrofa triage wymaga różnicowania z niewielu osób ciężko rannych, którzy mogą być zapisywane natychmiastowej interwencji ze strony wielu innych z nie zagrażających życiu obrażeń u których leczenie może być opóźnione. </span><span style="margin: 0px; padding: 0px;">Dylematy etyczne, które powstają są spowodowane przede wszystkim konieczności zdecydować, kto powinien być aktywnie leczona, lub w późniejszym terminie, czy przerwać leczenie z powodu urazów uznanych unsurvivable lub niekompatybilny z przetrwania w środowisku domowym.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Triage sortuje pacjentów na cztery grupy [ </span><a href="https://uroweb.org/guideline/urological-trauma/#note_398" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">398</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/urological-trauma/#note_399" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">399</span></a><span style="margin: 0px; padding: 0px;"> ]:</span></div> <div class="bodytekst_opsomming_cijfers_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">1.</span></span><span style="margin: 0px; padding: 0px;"> Pacjenci z zagrażających życiu obrażeń, które wymagają natychmiastowej interwencji, prezentując z obturacją dróg oddechowych, niewydolność i / lub krążenia kompromis z trwającej krwotoku zewnętrznego oddechowych;</span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">2.</span></span><span style="margin: 0px; padding: 0px;"> Pacjenci z ciężkimi, lecz nie zagrażających życiu obrażeń, u których leczenie może być zadowalająco opóźnionych, w tym tych z głównych złamań, urazów naczyniowych kończyn i dużych ran tkanek miękkich;</span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">3.</span></span><span style="margin: 0px; padding: 0px;"> spacerem rannych ", czyli ofiary z minimalnymi obrażeniami;</span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">4.</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Pacjenci, którzy są tak poważne obrażenia, że leczenie będzie wymagało alokacji zasobów i czasu, który uniemożliwiłby terminowej opieki dla innych pacjentów z większą przeżywalność. </span><span style="margin: 0px; padding: 0px;">Pacjenci ci są podane minimalne lub żadne leczenie i są poddane ponownej ocenie, gdy staną się dostępne zasoby. </span><span style="margin: 0px; padding: 0px;">Nie ma bezwzględnej definicji tej grupy, ponieważ sTriage jest indywidualnie, w zależności od ilości i nasilenia strat związanych z dostępnych zasobów. </span><span style="margin: 0px; padding: 0px;">Decyzja o wdrożeniu tej kategorii decyduje, kiedy wystarczająca informacja o incydencie jest dostępne i jest wykonany na najwyższym możliwym poziomie.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Triage należy wykonać na każdym etapie od ustawienia sprzed szpitala na pogotowie i powtarzać w miarę rozwoju sytuacji klinicznej. </span><span style="margin: 0px; padding: 0px;">Ostatecznie, jednostka odpowiedzialna za to jest odpowiedzialne za kierowanie specjalności chirurgicznych zespołami, w tym urologów i przypisanie im odpowiedzialności za konkretnych pacjentów, jak to podyktowane szczególnymi urazów.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_5_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.5.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Urologiczny rolę w ustalaniu masa wypadkowych</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Konsultacje urologiczne podczas scenariusza masa nieszczęśliwych wypadków należy przestrzegać zasad opisanych poniżej:</span></div> <div class="bodytekst_opsomming_cijfers_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">1.</span></span><span style="margin: 0px; padding: 0px;"> Zasada pod sTriage przez lekarza odpowiedzialnego za i wykonać szybki podstawowy przegląd każdego pacjenta;</span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">2.</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Unikaj zbędnych procedur obrazowania, takich jak skanowanie i wsteczny urethrography CT. </span><span style="margin: 0px; padding: 0px;">Procedury te powinny być wykonane później, po ponownej oceny pacjenta, a po masy protokoły wypadków zostały zawieszone;</span></span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">3.</span></span><span style="margin: 0px; padding: 0px;"> leczeniu pacjentów niestabilnych, które mają mieć operację z zastosowaniem zasad kontroli uszkodzeń;</span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">4.</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Pacjenci Stabilne powinny zostać przeniesione do oddziału chirurgicznego bez procedur obrazowania. </span><span style="margin: 0px; padding: 0px;">Ponowna ocena, czy istnieje jakakolwiek zmiana ich stanu hemodynamicznego, albo gdy jest to możliwe, jak podyktowane ograniczeniami imprezy masowe wypadku;</span></span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">5.</span></span><span style="margin: 0px; padding: 0px;"> 'Minimalna dopuszczalna "traktowanie wszystkich urologicznych urazów powinny być wykonywane w celu przeniesienia pacjentów na oddziałach chirurgicznych i zostały opisane powyżej w pkt 5.4 Urologicznego zarządzania szkody w urazie.</span></div> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_5_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.5.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Podsumowanie dowodów i zalecenia na imprezy masowe nieszczęśliwych wypadków</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Najnowsze wielkogabarytowe konflikty militarne podniosły standard praktyce dla pacjentów urazowych.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">4</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Centralizacja opieki urazowej oraz utworzenie centrów urazowych skutkuje lepszymi wynikami dla pacjentów urazowych.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Urolodzy mają ważną rolę do odegrania w leczeniu pacjentów urazie.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">4</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Postępuj zgodnie z zasadami kontroli uszkodzeń w leczeniu niestabilnych pacjentów urazowych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Upewnić się, że zespoły medyczne są dobrze przygotowani do radzenia sobie ze zdarzeniami urazie.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Upewnić się, że wszystkie chirurgiczne sub-specjalistów zajmujących się zarządzaniem traumy są zaznajomieni z zasadami triage i kontroli uszkodzeń.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> </tbody></table> </div> <div style="background-color: white; border: 0px; clear: both; color: #585858; font-family: Helvetica, Arial, sans-serif; font-size: 16px; font-stretch: inherit; line-height: 28px; margin: 0px; padding: 0px; vertical-align: baseline;"> </div> <div id="share-post" style="background-color: white; border: 0px; 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URAZY UKŁADU MOCZOWEGO (UROLOGICZNE) - WYTYCZNE EUROPEJSKIEGO TOWARZYSTWA UROLOGICZNEGO (4/4)

4.5.3.  Organ specyficzne urazy narządów płciowych 4.5.3.1.  Prącia uraz 4.5.3.1.1.  Blunt uraz prącia Blunt uraz wiotkiego penisa...

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