利尿肾图在肾积水诊断及与慢性梗阻性肾病预后相关性的研究

发布时间：2018-02-02 05:21

本文关键词： 利尿肾图、肾积水梗阻性肾病　出处：《山西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：实验目的：1.利尿肾图在鉴别梗阻性与非梗阻性肾积水中的临床意义。2.评价利尿性肾图对患肾功能的评估,已决定是否保留患肾。实验方法：本项研究选取山西医科大学第二医院2012年06月～2013年03月门诊及住院患者中泌尿系彩超呈一侧肾功能良好,对侧肾积水的病例45例,涉及45侧肾输尿管。1.对所有患者进行全面系统的检查,明确病因。2.再对这些患者进行利尿肾图检查,测定患肾肾功能并根据图像曲线变化结果,结合患者确切诊断,计算出利尿肾图在诊断梗阻性与非梗阻性肾积水的确诊率。3.将部分梗阻和完全梗阻患者根据利尿肾图测定的肾功能指标,按照标准分为轻、中、重度三组。4.对这三组患者进行手术或其他方式解除梗阻。5.术后三个月复查利尿肾图并记录肾功能。6.比较各组手术前后平均GFR值,采用配对t检验,以确定肾功能损害到何种程度时,可直接切除患肾,无需解除梗阻。实验结果：一、利尿肾图能较准确的区分梗阻性与非梗阻性肾积水。确诊率为84.4% 二、当肾功能严重受损(GFR小于10ml/min/1.73m2)时,解除梗阻后肾功能无显著变化,若对侧功能良好,可选择切除患肾,预防患肾出现反复感染等并发症。结论： 1.利尿性肾图在诊断梗阻性与非梗阻性肾盂扩张方面有重要意义。2.根据检验结果利尿肾图能够较准确的对患肾功进行评估,已决定手术是否保留患。
[Abstract]:Objective: 1.The clinical significance of diuretic nephrography in differentiating obstructive and non-obstructive hydronephrosis. Methods: from June 2012 to March 2013 in the second Hospital of Shanxi Medical University, the renal function of one side was good in the outpatients and inpatients. 45 cases of contralateral hydronephrosis involved 45 sides of renal ureter. 1. All patients were examined systematically, and the etiology was determined. 2. Diurethrography was performed on these patients. The renal function of the patients was determined and the diagnosis was combined with the results of the changes of the image curve. Calculate diuretic nephrogram in the diagnosis of obstructive hydronephrosis and non-obstructive hydronephrosis diagnosis rate. 3. Partial obstruction and complete obstruction according to the diuretic nephrogram measurement of renal function indicators, according to the criteria divided into light, moderate. Severe three groups. 4. The three groups of patients were operated on or other ways to relieve the obstruction. 5. Check the diuretic nephrogram three months after operation and record the renal function. 6. Compare the average GFR value before and after operation in each group. A paired t test was used to determine the extent of renal function damage, without removing obstruction. Experimental results: One, diuretic nephrogram can distinguish obstructive and non-obstructive hydronephrosis more accurately. The diagnosis rate is 84.4%. Second, when GFR was less than 10 ml / min / 1.73 m ~ (2), there was no significant change in renal function after relieving obstruction. If the contralateral function was good, the affected kidney could be resected. To prevent complications such as repeated infection of the affected kidney. Conclusion: 1. Diuretic nephrography is of great significance in the diagnosis of obstructive and non-obstructive dilatation of the renal pelvis. 2. According to the results of the test, diuretic nephrography can accurately evaluate the renal function of the patients and has decided whether to retain the patients.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692

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