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1、226中华小儿外科杂志2000年8月第21卷第4期ChinJPediatrSurg,August2000,Vol.21,No.4#临床研究#小儿重度肾积水术后肾功能的评价杨屹吉士俊赵国贵王常林侯英张彩霞徐薇娜=摘要>目的观察重度肾积水患儿术后肾脏功能的恢复情况及影响因素。方法利用ECT检查,测定50例患儿术后患肾功能,20例患儿手术前后患肾功能,并分析影响患肾功能恢复的因素。结果50例患儿术后患肾功能平均为(40.62?10.09)%,其中32%的患儿术后患肾功能接近正常,分肾功能达45%以上。20例患儿手术前后患肾功能分别为(20.45?
2、9.50)%和(37.10?9.16)%,患肾功能提高(16.73?11.51)%(P=0.0005)。术中测量的患肾实质厚度和术后患肾功能的恢复呈负相关(r=-0.79,P=0.004);随访时间和术后患肾功能的恢复呈正相关(r=0.76,P=0.014);手术时年龄和患肾功能恢复无显著相关性(r=-0.57,P=0.12)。肾外型肾积水术后患肾功能恢复明显高于肾内型肾积水(P=0.044)。结论重度肾积水患儿术后患肾功能可获得很好的恢复,部分患儿患肾功能恢复接近正常,应保留患肾。肾实质薄者,随访时间长者及肾外型肾积水患肾功能恢复明显。=
3、关键词>肾;肾积水;放射学;肾功能试验AppraisalofrenalfunctioninchildrenwithseverehydronephrosisafteroperationYANGYi,JIShi-jun,ZHAOGuogui,etal.Dept.ofPediatricSurgery,The2ndClinicalHospital,ChinaMedicalU-niversity,Shengyang110003,China=Abstract>ObjectiveToobservetheconvalescenceandfactorsinf
4、luencingontherenalfunctioninchildrenwithcongenitalhydronephrosisafteroperation.MethodsThepostoperativerenalfunctionof50casesandpreoperativeandpostoperativerenalfunctionof20patientsweredeterminedbyECT.Factorsthatinfluencedontheconvalescencewereanalyzed.ResultsTheaveragepost
5、operativerenalfunctionof50caseswas40.62?10.09%.Therenalfunctionofsomepatients(32%)wasnearnormal.Thediffer-entiatedrenalfunctionreachedupto45%.Theaveragepreoperativeandpostoperativerenalfunctionof20caseswas20.45?9.50%and37.10?9.16%respectively.Theparenchymathicknesswasnegat
6、ivelycor-relatedwithpostoperativerenalfunction(r=0.79,P=0.004).Thefollow-upperiodwaspositivelycor-relatedwithpostoperativerenalfunction(r=-0.57,P=0.12).Therecoveryofrenalfunctioninhy-dronephrosiswithextrarenalpelviswasobviousthanthatwithintrarenalpelvis(P=0.044).Conclusion
7、sThepostoperativerenalfunctioninchildrenwithhydronephrosiscanrecovertonormal.Therecoveryisob-viousincaseswiththinnerrenalparenchyma,longerfollow-upandextrarenalpelvis.=Keywords>Kidney;Hydronephrosis;Radiology;Kidneyfunctiontests小儿肾积水是常见的小儿泌尿系先天畸形,多资料与方法需手术治疗,自肾盂输尿管成形术开展以来使
8、患肾切除率显著下降。对于术前特别是术中决定患肾的1.临床资料从1986年5月~1998年12月取舍这一问题,根据对肾实质的病理观察发现,肾实我科共收治先天性肾积水320例,我们对