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題名 | The Role of Diuretic Renography in the Evaluation of Obstructed Hydronephrosis after Pediatric Pyeloplasty=利尿劑核醫腎臟攝影在評估小兒腎盂整形術後的阻塞性腎水腫的角色 |
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作者 | 王大民; 張慧朗; 高潘福; 謝明里; 黃世聰; 崔克宏; | 書刊名 | 長庚醫學 |
卷期 | 27:5 2004.05[民93.05] |
頁次 | 頁344-350 |
分類號 | 415.819 |
關鍵詞 | 利尿劑核醫腎臟攝影; 腎盂整形術; 腎水腫; Hydronephrosis; Pyeloplasty; Diuretic renography; |
語文 | 英文(English) |
中文摘要 | 背景:本研究的目的是在釐清核醫腎臟攝影的腎臟排泄半衰期在評估小兒腎盂整形術後的阻塞性腎水腫的價值。 方法:我們回溯30個沒有合併其他泌尿系統異常的單側腎盂輸尿管交接處阻塞並且接受腎盂整形術的病童的病歷記錄。所有的病童的術後追蹤時都超過5年。術前和術後的評估包有DMSA的核醫腎臟攝影、DTPA利尿劑的核醫腎臟攝影和腎臟超音檢查等。根據手術後的核醫腎臟攝影的腎臟排泄半衰期,我們將病童皆為兩組來評估來其腎臟排功能的狀況,其中A組是正常排泄半衰期,B組是延長的排泄半衰期。 結果:手術後的利尿劑核醫腎臟攝影結果顯示54%(A組)的病童是正常排泄,而46%(B組)是排泄時間延長。其中正常排泄半衰期的A組中有92%以及延長排泄半衰期的B組中有91%的術後腎臟功能追蹤是屬於穩定或有所改善。兩組之間對於腎盂前後徑改善的比較並沒有統計學上的意義。而且所有的病童術後的腎臟超音波檢查所算出的腎盂前後徑都比術前改善。 結論:腎臟排泄半衰期的在評估小兒腎盂整形術後的阻塞性腎水腫並不是一個相當可靠的指標。我們建議在評估阻塞性的腎水腫時除了參考腎臟排泄半衰期之外應該同時慮到腎盂前後徑的大小以及個別腎臟功能的比例。 |
英文摘要 | Backgorud: The purpose of this study was to clarify the value of renal drainage half-time in the evaluation of pediatric hydroneplhrosis after dismembered pyeloplasty. Mthods: We reviewed the records of 30 children who underwent dismembered pyeloplasty for unilateral ureteropelvic junction obstruction with no other associated urological abnormality. The follow-up duration was more than 5 years for all patients. Pre-and postoperative evaluation included tenchnetium-99m dimercaptosuccinic acid (99mTc-DMSA) renal scan, technetium-99m diethyl-enetriaminepentaacetic acid (99mTc-DMSA) diuretic renal drainage half-time on diuretic renography, patients were divided into 2 groups: group A with normal renal drainage and group B with prolonged renal drainage for evaluation of their renal functional status. Results: Postoperative diuretic renography revealed normal drainage (group A) in 54% Of patients and prolonged drainage (group B) in 46%. The anteroposterior diameter (APD) of the renal pelvis of all patients showed improvement after pyeloplasty. There was no significant difference in improvement of the renal pelvic APD between the 2 groups. Furthermore, 92% of group A and 91% of group B maintained stable or had improved differential renal function (DRF) postoperatively. Conclusions: drainage half-time is not a reliable parameter for diagnosing obstructed hydronephrosis after pediatric pyeloplasty. We suggest that the renal pelvic APD and DRF would be considered when postoperative obstructed hydronephrosis is diagnosed using the criterion of prolonged renal drainage half-time on diuretic renography. @@@ |
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