利尿肾图在肾积水诊断及肾盂成形术疗效评价中临床意义的研究

The study on the clinical significance of diuresis renography in the diagnosis of hydronephrosis and pyeloplasty

目的：探讨利尿肾图在鉴别梗阻性与非梗阻性肾积水中的临床意义。方法：选择门诊及住院患者56例，涉及56侧肾输尿管。记录入选者一般情况和既往史，做普通肾图。对普通肾图呈梗阻型患者，按一次法做利尿性肾图，观察排泄曲线及速率。根据相关指标计算使用利尿剂后的排泄指数（DEI）。参与的病例最终均经B型超声检查，静脉肾盂造影或手术确诊。计算利尿肾图的确诊率。选取利尿肾图呈部分和完全梗阻的病例行。肾盂成形术，术后随访6～8个月，根据利尿肾图曲线及排泄率的变化对术侧肾脏做手术前后对比并对结果作秩转换的非参数检验。结果：如果利尿性肾图呈梗阻样，肾盂出口与输尿管梗阻可能性非常大。如果利尿性肾图是阴性的，说明肾盂输尿管是通畅的，可能肾盂扩张或张力下降，为动力性肾盂积水。利尿肾图检查显示手术（肾盂成形术）前后，肾孟积水改善明显。结论：利尿性肾图是诊断梗阻性与非梗阻性肾盂扩张的首选检查方法。利尿性肾图可作为手术（肾盂成形手术）后功能恢复的监测手段。

Objective：Diuresis renography in differentiating obstructive and clinical significance of non obstructive hydronephrosis. Methods：This article selects outpatient and inpatient 56 cases involving 56 side kidney ureter, the general condition and past medical history records list, regular, normal operation, to do normal kidney. In patients with normal kidney is obstruction type, according to a method for diuresis renography. Observed discharge curve and rate. According to the index of the discharge calculation after the use of diuretics （collection）. Ultimately,involved in cases by type B ultrasound ,intravenous urography imaging diagnosis or surgery. The positive rate of diuresis renography calculation. Select diuresis renography is part of the line and complete obstruction cases pyeloplasty, postoperative follow-up 6 - 8 months, according to the variation of diuresis re- nography curve and the discharge rate of side kidney for comparison before and after operation and the rank conversion of non-parametric test results. Select diuresis renography is part of the line and complete obstruction cases pyeloplasty, postoperative follow-up 6 -8 months, according to the variation of diuresis renography curve and the discharge rate of side kidney for comparison before and after operation and the rank conversion of nonparametrie test results. Results： If the diuresis renography is obstruction sex, the possibility is very large. Exports of the renal pelvis and ureter obstruction. If diuresis renography is negative, is given to illustrate the patency of the renal pelvis ureter, expansion of the renal pelvis or tension decreased, for the performance of hydronephrosis. Diuresis renography examination showed before and after surgery （pyeloplasty）, hydronephrosis improve significantly. Conclusion：Diuresis renography diagnosis in the diagnosis of obstructive and obstructed the first choice for the expansion of the renal pelvis. Diuresis renography may be as a functional recovery after operation （surgery） of renal pelvis forming methods of monitoring.