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

Postoperative Urinalysis in Obstructive Hydronephrosis and Its Clinical Significance

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。

Urine from the hydronephrotic and contralateral kidneys of 21 patients with unilateral hydronephrosis was collected from t he 6th to 8th postoperative day for determining the concentration of Mg++,Na+,Cl-,Ca++,K+,β2M and renal glornerular 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+andβ2M between hydronephrotic and contralateral kidneys.The authors conclude that the impairment of tubular filtration function was severer than reabsorbing function of glomerlar in hydronephrotic 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.