169例多囊肾临床研究

Clinic study on 169 cases of polycystic kidney

目的对多囊肾病人进行必要的临床分期,并对去顶减压手术进行较为正确的评估。方法对169例多囊肾病例进行了分析。根据多囊肾病人的血压、肾功能、年龄将多囊肾分为三期,对手术病人手术前后临床症状、血压、肾功能进行了比较并随访。结果一、二期多囊肾病人术前血压平均为18.2/12.4、19.8/14.2kpa,BUN为9.8、12.1mmol/L,Cr为166、186μmol/L。术后血压平均为17.1/11.2、19.2/12kpa,BUN为8.2、10.1mmol/L,Cr为147、162μmol/L。经统计,手术前后患者血压、肾功能差异存在着显著性,而三期病人术前术后除临床症状有所改善外,其他无差异。有58例随访1～10年,其中一、二期病人52例,病情发展较为缓慢,临床症状明显改善。结论选择性的对一、二期病人进行去顶减压手术对改善症状,降低血压、延缓肾功能衰竭具有良好的效果。

[Objective] To evaluate the cystic decompression（CD） operation on polycystic kidney disease according to the clinical stage. [Methods] Three main parameters, age, blood pressure and renal function, were observed pre-operatively and post-operatively in 169 patients who took CD operation. Necessary follow-up was carried out. [Results] The preoperative mean blood pressure in 1st and 2nd stage were： 18.2/12.4 Kpa and 19.8/14.2 Kpa, BUN were 9.8 and 12.1 mmol/L, Cr were 16.6 and 18.6 μmol/L, respectively. After CD operation, blood pressures of the 1st and 2nd stage patients were 17.1/11.2 Kpa and 19.2/12.1 Kpa, BUN were 8.2 and 10.1 mmol/L Cr were 147 and 162 μmol/L, respectively. Statistic analysis found that there were obvious changes pre- and post-operatively in 1st and 2nd stage patients. For 3rd stage patients who took CD, there was subjective improvement on clinical symptoms, blood pressure and renal function. A follow-up of 58 patients （including 52 1st and 2nd stage patients） for 1-10 years showed that there was obvious improvement in clinic symptoms, and a slowdown of chronic renal failure progression. [Conclusion] For the 1st and 2nd stage polycystic kidney patients, CD operation can improve clinic symptoms, lower blood pressure and slowdown chronic renal failure.