多普勒超声在儿童先天性单侧肾积水诊断与治疗中的价值  

The role of Doppler ultra - sonography in the diagnosis and treatment of congenital unilateral hydronephroses in children

作　　者：杜涛[1] 乔保平[2] 赵冰[1] 高永举[1] 宋少康[1] 王飞杰[1] 

机构地区：[1]河南省人民医院泌尿外科,郑州450003 [2]郑州大学第一附属医院

出　　处：《中原医刊》2007年第9期8-9,共2页Central Plains Medical Journal

摘　　要：目的探讨彩色多普勒超声对儿童先天性单侧肾积水的鉴别诊断和治疗的价值。方法对30例先天性单侧肾积水。对侧肾脏正常的儿童的诊断和治疗过程进行研究。利用彩色多普勒测定双肾阻力指数，对比阻力指数及相关指标与利尿后肾图鉴别单侧梗阻性和非梗阻性肾积水的结果差异。利用肾脏动态核素扫描计算双肾的肾小球滤过率，比较利尿后双肾阻力指数的比值与双肾肾小球滤过率的比值之间有无相关性。结果阻力指数与利尿后肾图鉴别儿童单侧梗阻性和非梗阻性肾积水的结果差异有统计学意义；阻力指数率、利尿后阻力指数率与利尿后肾图的鉴别结果差异无统计学意义。利尿后，双肾阻力指数的比与双肾肾小球滤过率的比之间存在密切负相关关系。结论通过彩色多普勒超声测定阻力指教有助于鉴别儿童先天性单侧梗阻性和非梗阻性肾积水。对比利尿后双肾阻力指数的差异有助于评估梗阻肾的功能状态从而为治疗的时机和预后提供参考。Objective To explore the role of Doppler ultrasonography in diagnosing and treating congenital unilateral hydronephroses in children. Methods Thirty children with congenital unilateral hydronephroses and normal contra -lateral renal were studied. To evaluate whether or not there is a significant difference in differing obstructive from non - obstructive hydronephroses between post - diuretic renogram and resistive index （RI） or related indexes determined by Doppler ultrasonography. The relation of the ratio of bilateral renal RIs to the one of bilateral renal glomerular filter rates （GFRs） calculated by ECT after administrating diuretics was also determined. Results A significant difference was found between the results of differential diagnosis by the RI ratio or post - diuretic RI ratio and post - diuretic renogram. However, there was no statistical significance between the RI and post - diuretic renogram. A close negative correlation was proved between the ratio of bilateral RIs and the one of bilateral GFRs after the administration of diuretics. Conclusion The contrast of bilateral renal RIs determined by Doppler uhrasonography may contribute to the differential diagnosis between obstructive and non - obstructive hydronephroses. The status of obstructive renal function may be known by comparing post - diuretic bilateral renal RIs, offering reference for the timing for the treatment and the prognoses.

关 键 词：肾脏 超声 多普勒 泌尿道 积水 

分 类 号：R726[医药卫生—儿科] R44[医药卫生—临床医学]