肾积水患儿手术前后临床指标参数变化及随访价值分析  

The Changes and Follow-up Value of Clinical Parameters in Children with Hydronephrosis Before and After Operation

作　　者：吴云 周静[1] 金成 WU Yun;ZHOU Jing;JIN Cheng(Department of Urology,Children′s Hospital Affiliated to Nanjing Medical University,Nanjing 210001,China)

机构地区：[1]南京医科大学附属儿童医院泌尿外科

出　　处：《标记免疫分析与临床》2019年第12期2038-2042,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的分析肾积水患儿手术前后临床指标参数变化及随访价值。方法选择2016年1月至2018年7月于我院行肾盂输尿管成形术治疗的肾积水患儿进行随访研究(其中术前轻度肾积水15例,中度肾积水24例,重度肾积水29例),利用超声检测肾盂前后径(PD)及肾实质厚度(PT),计算PD/PT比值,分析肾积水患儿术后病肾变化。结果术后同一程度肾积水患儿病肾PD、PT、PD/PT比值及GFR、DRF值与术前比较均有显著改善(P<0.05),但术后轻度与中度肾积水患儿病肾PD、PT、PD/PT比值及GFR、DRF值比较差异无统计学意义(P>0.05),术后轻度与重度、中度与重度肾积水患儿病肾PD、PT、PD/PT比值及GFR、DRF值比较差异有统计学意义(P<0.05);轻度及中度肾积水患儿术后双侧肾脏PD、PT、PD/PT比值及GFR、DRF值比较差异无统计学意义(P>0.05),重度肾积水患儿术后病肾PD、PT、PD/PT比值及GFR、DRF值与健肾差异仍有统计学意义(P<0.05);Spearman相关性分析显示,术后病肾PD/PT比值与术前肾积水程度显著正相关(r=0.460),与术后随访时间显著负相关(r=-0.342);GFR、DRF值与术前肾积水程度显著负相关(r=-0.394、-0.352),与术后随访时间显著正相关(r=0.580、0.522);术后病肾PD/PT比值与GFR、DRF值显著负相关(r=-0.610、-0.592);GFR、DRF值之间显著正相关(r=0.614)。结论肾积水患儿术后临床指标均有显著改善,通过超声检测病肾PD/PT值具有操作简便、微创和可重复性的优势,可作为评估术后病肾变化的随访观察指标。Objective To analyze the changes and follow-up value of clinical parameters in children with hydronephrosis before and after operation.Methods Children with hydronephrosis(15 cases of mild hydronephrosis,24 cases of moderate hydronephrosis,and 29 cases of severe hydronephrosis before the operation)treated with pyeloureteroplasty in the hospital from January,2016 to July,2018 were followed up for the study.The anteroposterior pelvic diameter(PD)and renal parenchymal thickness(PT)were detected by ultrasound.The PD/PT ratio was calculated and combined with glomerular filtration rate(GFR)and renal function(DRF)detected by ureteral intubation to analyze the postoperative renal changes in children with hydronephrosis.Results The PD,PT,PD/PT ratio,GFR and DRF values of diseased kidney in children with the same degree of hydronephrosis were significantly improved after the operation(P<0.05).There was no significant difference among above indicators between children with mild and moderate hydronephrosis after the operation(P>0.05),but there were significant differences in those indicators between children with mild and severe hydronephrosis,as well as with moderate and severe hydronephrosis after the operation(P<0.05).There was no significant difference in PD,PT,PD/PT ratio,GFR or DRF of bilateral kidneys in children with mild and moderate hydronephrosis after the operation(P>0.05).There were significant differences in PD,PT,PD/PT ratio,GFR and DRF between diseased kidneys and healthy kidneys in children with severe hydronephrosis after the operation(P<0.05).Spearman correlation analysis showed that the PD/PT ratio of diseased kidney after the operation was significantly positively correlated with the degree of hydronephrosis before the operation(r=0.460),and was significantly negatively correlated with postoperative follow-up time(r=-0.342).GFR and DRF values were significantly negatively correlated with the degree of hydronephrosis before the operation(r=-0.394,-0.352),and were significantly positively correlated with p

关 键 词：肾积水 肾盂前后径 肾实质厚度 肾小球滤过率 

分 类 号：R69[医药卫生—泌尿科学]