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其他题名Delayed parenchymal transit time on 99Tcm-DTPA diuretic renography in predicting functional improvement of ureteropelvic junction obstruction after surgery
付占立; 邸丽娟; 范岩; 张旭初; 张建华; 王荣福
关键词输尿管梗阻 泌尿外科手术 肾小球滤过率 放射性核素显像 Dtpa Ureteral Obstruction Urologic Surgical Procedures Glomerular Filtration Rate Radionuclide Imaging Dtpa
收录类别中国科技核心期刊 ; CSCD
文章类型Journal Article
摘要目的 探讨99Tcm-DTPA利尿肾动态显像皮质通过时间(pTT)作为预测肾盂输尿管连接部狭窄(UPJO)离断式肾盂成形术后肾功能改善指标的可行性.方法 回顾性分析47例[男37例,女10例,年龄(29.7±10.8)岁]单侧UPJO患者临床情况及手术前后99Tcm-DTPA利尿肾动态显像,记录患者的年龄、性别、患肾位置、梗阻类型、手术方式、相对肾功能[RRF(患肾放射性摄取占总肾的百分比)]以及PTT,评价不同因素或指标对术后患肾RRF改善率(术后与术前RRF差值)的影响.符合以下情况之一即为PTT延迟:(1)在第2~7帧慢动态影像上,积水肾盂内未见放射性;(2)在第2~9帧慢动态影像上,肾皮质放射性无变化,肾大小、形态变化不明显;(3)肾皮质放射性持续增加;(4)自慢动态第2帧影像始,肾皮质放射性清除较对侧正常肾慢.采用配对t检验、Kruskal-Wallis及MannWhitney秩和检验和Pearson相关分析对数据进行统计学分析.结果 术后患肾RRF高于术前,分别为(40.70±13.30)%、(44.96±12.60)%,t=4.19,P<0.01.PTT延迟组(16例)RRF改善率显著高于PTT正常组(27例),分别为(11.69±6.52)%、(0.48±2.98)%,Z=-5.13,P<0.01;4例患肾PTT不能明确判断延迟或正常.术前不同RRF(<40%与≥40%)、梗阻类型(机械性与非机械性)、患肾位置(左与右)、手术方式(开放手术与腹腔镜手术)以及性别(男与女)组间的患肾RRF改善率差异均无统计学意义(Z=-1.93~ 1.25,均P>0.05).患肾RRF改善率与患者年龄之间未见有统计学意义的相关性(r=0.01,P>0.05).结论 99Tcm-DTPA利尿肾动态显像PTT延迟是预测UPJO患者术后肾功能改善的唯一有效指标. Objective To evaluate the usefulness of delayed parenchymal transit time (PTT) on 99TcmDTPA diuretic renography as a predictor for functional improvement after Anderson-Hynes dismembered pyeloplasty in patients with ureteropelvic junction obstruction (UPJO).Methods Forty-seven patients (37males,10 females,age (29.7± 10.8) years) with unilateral U PJO were retrospectively analyzed.All patients underwent 99Tcm-DTPA diuretic renography before and after the surgery.Patient age,sex,UPJO location,surgical methods,relative renal function (RRF) of the diseased kidney (uptake ratio of UPJO kidney to both kidneys),and PTT were recorded.Delayed PTT was defined as having one of the following criteria: (1) photopenic pelvis between the second and seventh frame; (2) relatively stable tracer distribution within the kidney between the second to ninth frame with nearly unchanged kidney shape and size; (3) ever increasing activity in the parenchyma; (4) slower clearance from the parenchyma into the pelvis since the second frame compared with the contralateral healthy kidney.The relationship between the above-mentioned factors and RRF improvement (RRFpvst-surgery,-RRFpre-sugery) was analyzed.Paired t test,Kruskal-Wallis and Mann-Whitney rank sum tests and Pearson correlation analysis were used.Results The average RRF of pre-and post-surgery was (40.70± 13.30) % and (44.96 ± 12.60) %,respectively (t =4.19,P < 0.01).RRF improvement between the delayed group (n=16) and normal timely PTT group (n=27) was significantly different: ((11.69±6.52) % vs (0.48±2.98) %,Z=-5.13,P<0.01).The assessment of delayed or normal PTT could not be determined in 4 patients.No statistically significant differences of RRF improvement were found between pre-surgery RRF < 40% and RRF ≥ 40% groups,between left and right UPJO groups,between open surgery and laparoscope groups,between male and female patients (Z =-1.93 to 1.25,all P>0.05).There was no significant correlation between RRF improvement and patient age (r =0.01,P>0.05).Conclusion Delayed PTT on 99Tcm-DTPA diuretic renography might be the predictor for functional improvement post surgery in UPJO patients.
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GB/T 7714
付占立,邸丽娟,范岩,等. 99Tcm-DTPA肾皮质通过时间延迟预测肾盂输尿管连接部狭窄术后肾功能改善的价值[J]. 中华核医学与分子影像杂志,2014,34(1):39-42.
APA 付占立,邸丽娟,范岩,张旭初,张建华,&王荣福.(2014).99Tcm-DTPA肾皮质通过时间延迟预测肾盂输尿管连接部狭窄术后肾功能改善的价值.中华核医学与分子影像杂志,34(1),39-42.
MLA 付占立,et al."99Tcm-DTPA肾皮质通过时间延迟预测肾盂输尿管连接部狭窄术后肾功能改善的价值".中华核医学与分子影像杂志 34.1(2014):39-42.
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