小儿先天性肾积水解除梗阻后尿量和尿成分的测定及其临床意义

摘要

Urine from the hydronephrotic and contralateral kidneys of 21 patients with unilateral hydronephrosis was collected from the 6th to 8th postoperative day for determining the concentration of Mg~(++),Na~+,Cl~-,Ca~(++),K~+,β_2M and renal glomerular filtration rate (RGFR).The RGFR in 3 of 18 cases was less than 25%.The excretory fraction of Mg~(++),Na~+,Cl~- and excretion of Mg~(++) were higher in hydronephrotic kidneys.There was no significant difference in excretion of Na~+,K~+ and β_2M between hydronephrotic and contralateral kidney.The authors conclude that the impairment of tubular filtration function was severer than reabsorbing function of glomerlar in hydronephrotie kidney.It may be the reason of postoperative diuresis.Determination of Mg~(++) excretion in urine appears to be helpful to assessment of the degree of tubular deterioration.%测定积水肾肾小球及肾小管功能,了解尿液测定的临床意义.对21例单侧先天性肾积水进行研究,术后6～8天分别收集健患两肾尿液,测定Mg~(++)、Na~+、Cl~-、Ca~(++)、K~+、β_2M及相对肾小球滤过率(RGFR).结果,患肾对Mg~(++)、Na~+、Cl~-的排泄分数增高,Mg~(++)的排泄量增高,Ca~(++)、K~+、β_2M改变不明显,对其中18例测定RGFR,3例GFR＜25%.说明患肾肾小球滤过功能受损轻,肾小管再吸收功能受损重,二者受损程度不一致是导致解除梗阻后多尿的原因.尿Mg~(++)的测定有助于估计肾小管功能受损情况.