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目的 探讨利尿性肾图 (DR)在评估小儿上尿路扩张术后疗效中的价值。 方法 对5 4例 (6 6侧 )上尿路扩张术后患儿随访资料进行回顾性分析。 结果 5 4例患儿根据肾血流灌注率(BPR)值分为轻、中、重度三组。轻、中度组 (49侧 )肾图术前为无排泄相的梗阻图型 ,术后排泄相出现 ,其中注射速尿后明显下降者 37侧 ,无变化 12侧。重度组 (17侧 )BPR术前为 (2 3.8± 3.5 ) % ,术后为 (33.4± 6 .4 ) % ,差别有显著性意义 (P <0 .0 1)。肾图术前为低平的梗阻图型 ,术后吸收排泄相有所改善 ,注射速尿后曲线加快下降者 10侧 ,无变化 7侧。 2例术后 2周和 4 0d复查DR ,肾图曲线由术前排泄延迟型转为梗阻型 ,半年后又转为排泄延迟型。 结论 肾图曲线变化是判断轻、中度上尿路扩张术后疗效的重要指标。BPR是判断重度上尿路扩张术后肾功能恢复的重要指标。DR随访时间以术后半年为宜
Objective To investigate the value of diuretic renal mapping (DR) in assessing the efficacy of upper urinary tract dilatation in children. Methods Retrospective analysis was performed on the follow-up data of 54 cases (66 sides) of children with upper urinary tract dilatation. Results Fifty-four children were divided into mild, moderate and severe groups according to the renal perfusion rate (BPR). In the mild group and the moderate group (49 sides), the obstruction pattern without excretion phase before the nephrogram was found, and the excretion phase appeared after operation. The markedly decreased 37 cases and no change 12 sides after the injection of furosemide. In the severe group (17 sides), the preoperative BPR was (2.38 ± 3.5)% and the postoperative was (33.4 ± 6.4)%, the difference was significant (P <0.01). Nephrectomy for low flat obstruction pattern, postoperative absorption of excretion phase improved, after injection of furosemide curve accelerated decline in 10 sides, no change in 7 sides. Two patients underwent 2-week and 4-day follow-up examinations of DR. Renogram curves were delayed from preoperative excretory delay to obstructive and postoperative excretion delayed six months later. Conclusion The change of renal angiogram curve is an important index to judge the curative effect after light and moderate upper urinary tract dilatation. BPR is to judge the recovery of renal function after severe upper urinary tract dilatation is an important indicator. DR follow-up time of six months after surgery is appropriate