分肾功能在成人单侧先天性肾盂输尿管连接部梗阻手术前后肾功能评价中的价值

摘要

目的：探讨分肾功能（DRF）在成人单侧先天性肾盂输尿管连接部梗阻（UPJO）手术前后肾功能评价中的价值。方法选取2008年1月-2012年12月诊断为成人单侧先天性UPJO患者32例，术前利用肾动态显像测定分肾功能，将患者分为3组（ DRF≥40％I组10例，30％≤DRF＜40％II组14例，DRF＜30％III组8例）。术后6个月再次复查并与手术前进行比较。结果术前患肾DRF≥40％（I组），术后患肾功能平均提高（2．18±3．25）％，与术前相比差异无显著性意义（P＝0．463）；术前患肾30％≤DRF＜40％（II组），术后患肾DRF平均提高（11．37±3．82）％，与术前相比差异有显著性意义（P＝0．000）；DRF＜30％（III组）术前术后平均DRF分别为（22．18±2．73）％和（24．35±3．56）％，差异无显著性意义（P＞0．05）。结论 DRF能预测UPJO解除梗阻后肾功能的恢复情况。30％≤DRF＜40％患者术后肾功明显改善，DRF≥40％与DRF＜30％患者术后肾功能无明显改善。%Objective To discuss the value of differential renal function in the assessment of renal function before and after adult unilateral congenital ureteropelvic junction obstruction pyeloplasty .Methods From January 2008 to December 2012 , 32 cases with adult unilateral congenital ureteropelvic junction obstruction were selected , whose differential renal function ( DRF) was measured preoperatively by Renal dynamic imaging .The patients were divided into three groups according to the preoperative DRF:Group I ( n=10 ) , DRF≥40%; Group II ( n=14 ) , 30%≤DRF<40%; Group III ( n=8 ) , DRF<30%.The patients’ DRF were re-examined 6 months post-operation and were compared to those of pre -opera-tion.Results For patients who had preoperative DRF ≥40%(Group I), postoperative DRF improved (2.18 ±3.25)%on average although the difference is not statistically significant (P=0.463).For patients who had preoperative DRF≥30%and <40%(Group II), the mean postoperative DRF improved (11.37 ±3.82)%, significantly different from the preoperative DRF (P=0.000).For patients who had preoperative DRF <30%(Group III), the preoperative DRF and postoperative DRF were (22.18 ±2.73)%and (24.35 ±3.56)%, respectively (P>0.05).Conclusion DRF can pre-dict the recovery of renal function after pyeloplasty .The patients with 30%≤DRF<40%have significantly improved renal function after surgery;whereas , the patients with DRF≥40% or DRF<30% have no significant renal function improve-ment .