小儿PUJO肾积水梗阻解除后尿成分的测定

A Clinical Study on Urinalysis after Obstruction Release in Children with PUJO Hydronephrosis

目的 通过测定肾盂输尿管连接部梗阻 (PUJO)肾积水患儿肾盂成形术后尿成分的变化 (包括Na+,K+,Cr,Mg2 +,Ca2 +,P ,UN ,UA) ,探讨其与肾小管损伤的关系和临床意义。方法 术后第6,7,8天每日分别收集 2 4h肾造瘘引流尿液及膀胱尿 ,Neclus生化分析仪测Na+,K+,Cr,UN浓度 ,Monarch 2 0 0 0生化分析仪测Ca2 +,P ,Mg2 +,UA浓度。计算健、患肾各种成分的术后排出水平 ,并与术前和正常儿对照。结果 Na+,Cr ,Mg2 +在患肾中排出总量较对侧多 ,而且双肾的Na+排出量存在正相关性 (r=0 .53 3 )。Na+,Cr,Mg2 +术后排出多于术前 (P <0 .0 5) ;单侧PUJO健肾排钠水平高于正常儿单肾(P <0 .0 5)。结论 梗阻解除后分肾尿成分出现变化 。

Objective The authors measured output of eight urine ingredients in the condition of split renal drainage after Anderson Hynes Pyeoplasty in children with PUJO Hydronephrosis,and tried to find their values in judging tubular injury and clinical significance.Method Urine from drainage tube and bladder was collected every 24 hour in 6～8 days after operation.The urine samples were examined separately by biochemical analysis instruments,the Neclus using for Na +,K +,Cr,UN concentration measurement,the Monarch 2000 for Ca 2+ ,P,Mg 2+ and UA.The output levels of eight ingredients were caculated in separate kidneys.Result The excretory amount of Na +,Cr,Mg 2+ was much more in the morbid kidney than that in the contralateral kidney and sodium output in bilateral kidneys had a positive correlation (r=0.533).Post operative excretory amount of Na +,Cr and Mg 2+ was much more than pre operation (P<0.05).The sodium excretory level was higher in the contralateral kidneys of unilateral hydronephrosis than in the normal single kidneys (P<0.05).Conclusion The urine ingredients changed after release of obstruction,some of them had a clinical significance in judging tubular injury and postoperative therapy.