肾小球滤过率测定+肾静态显像在输尿管结石手术治疗中的临床价值

The Clinical Value of Renal Dynamic Function and Static Imaging to the Surgical Treatment of the Calculus in Ureter

目的评价肾小球滤过率(GFR)测定+肾静态显像在输尿管结石手术治疗方案的选择及疗效观察的价值。方法56例输尿管结石患者分为肾摘除组(10例)和输尿管切开取石两组(46例),术前均行血清肌酐(SCr)、血尿素氮(BUN)测定,核素肾动态显像GFR测定及核素肾静态显像等检查,术后均复查SCr、BUN,其中26例术后一个月复查GFR测定及肾静态显像。结果肾摘除组摘除肾和输尿管切开取石组手术肾两组之间的GFR值、肾静态指数存在显著差异,且根据肾的GFR值、肾静态指数评估的肾功能状态与在手术中发现的肾的形态、结构相一致,输尿管切开取石组术后手术肾GFR值、肾静态指数有明显改善。结论肾GFR测定结合肾静态显像能更准确了解肾的功能、形态,对输尿管结石的手术治疗方案的选择和疗效观察具有重要意义。

Objective To evaluate the value of the glomerular filtration rate(GFR)measurement with 99 Tc m -DTPA and static imaging with 99 Tc m -DMSA to the determenation of surgical treatment protocal and efficience observing after the treatments.Methods 56cases were divieded into two groups,the First group in cluded10cases whose renal was cut off,and the second group included46case with the operation of calculus in ureter,the serum creatinine(SCr ),the Blood urea nitrogen(Bun)the GFR and the renal static imaging were per-formed for each case before the surgical treatment and the SCr,the Bun were also checked with each case af-ter the operation.26cases were repeated the measurement of GFR and the static imaging one month later.Re -sults the significant defference of the GFR and the index of the static imaging(ISI )was found between the two groups(t=-3.786,t=-6.48,P<0.001).the renal shape and its strature observed observed during the op era-tion were very cresponding to the suspious according to the GFR and the index of the static imaging,the GFR and the ISI were obviously improved in the second groups after the operation(t=-2.978,t=-3.427,P<0.05).Conclusions It was important to use the GFR measurement combining the renal static imaging to evalu ate the renal function and its shape before determining the treatment protocal,and also to observe the effeciene after the treatments.