肾动态显像评价肾结石积水患肾术后功能修复程度的研究

Renal Dynamic Imaging to Evaluation Repaired Degree of Renal Function in Postoperative in Renal Calculus with Effusion Patients

摘要: 目的：应用^99mTc-DTPA肾动态显像评估肾结石并积水患者术后患肾残余功能的恢复情况。方法：经B超和静脉肾盂造影(IVP)确诊为肾结石并积水的患者30例(患肾53只)，所有患者手术前后均进行^99mTc-DTPA肾动态显像测定分肾肾小球滤过率(glomerular filtration rate, GFR)。结果：30例受检患者的53只患肾术前^99mTc-DTPA肾动态显像均提示有残余肾功能，其中功能重度受损患肾27只，术前GFR为(6.16 ± 2.06) ml/min，术后GFR为(11.06 ± 5.96) ml/min；功能中度受损患肾22只，术前GFR为(17.13 ± 5.58) ml/min，术后GFR为(24.43 ± 7.20) ml/min；功能轻度受损患肾4只，术前GFR为(36.51 ± 4.71) ml/min，术后GFR为(46.67 ± 3.77) ml/min。肾功能轻度受损组、中度受损组及重度受损组与术前相比，GFR均有明显升高，差异有统计学意义，(P < 0.05)。结论：^99mTc-DTPA肾动态显像不仅能够提供分肾的GFR值，而且能够早期、无创的评价肾结石并积水患者术后患肾(分肾)功能恢复情况，为手术决策提供可靠的参数。

Abstract: [Objective] Application of ^99mTc-DTPA renal dynamic imaging to evaluation of residual renal function in postoperative patients with renal calculus with effusion. [Methods] 30 cases of renal calculus with effusion patients diagnosed by ultrasonic and intravenous pyelography (IVP) (53 kidneys), renal glomerular filtration rate (GFR) were measured by ^99mTc-DTPA renal dynamic imaging in all preoperative and postoperative patients. [Results] 53 kidneys all have residual renal function by renal dynamic imaging in preoperative in 30 cases of patients, 27 kidneys with Severe functional impairment, preoperative GFR (6.16 ± 2.06) ml/min, postoperative GFR (11.06 ± 5.96) ml/min; moderate impairment of renal function in 22 Kidneys, preoperative GFR (17.13 ± 5.58) ml/min, postoperative GFR (24.43 ± 7.20) ml/min; 4 kidneys with Impaired renal function, preoperative GFR (36.51 ± 4.71) ml/min, postoperative GFR (46.67 ± 3.77)ml/min. Compared with the preoperative group, GFR was significantly increased in all three groups, the difference was statistically significant(P < 0.05). [Conclusions] ^99mTc-DTPA renal dynamic imaging can not only provide the renal GFR, but also can assess the repaired degree of renal function in postoperative patients, provide reliable parameters for surgical decision-making.