Acker Matthew R, Clark Roderick, Anderson Peter
Department of Urology, University of Miami, Miami, FL, U.S.;
Division of Urology, University of Western Ontario, London, ON, Canada;
Can Urol Assoc J. 2016 Mar-Apr;10(3-4):96-100. doi: 10.5489/cuaj.3237.
As early detection of hydronephrosis increases, we require better methods of distinguishing between pediatric patients who require pyeloplasty vs. those with transient obstruction. Gravity-assisted drainage (GAD) as part of a standardized diuretic renography protocol has been suggested as a simple and safe method to differentiate patients.
Renal scans of 89 subjects with 121 hydronephrotic renal units between January 2004 and March 2007 were identified and analyzed.
Of all renal units, 65% showed obstruction. GAD maneuver resulted in significant residual tracer drainage in eight renal units, moderate drainage in 12 renal units, and some improvement in 40 units after the GAD maneuver. Of the eight renal units with significant residual tracer drainage, only two proceeded to pyeloplasty. After pyeloplasty, nine children had improved time to half maximum (T(1/2) Max) and 13 were unchanged.
Our study was limited due to its retrospective design and descriptive analyses, but includes a sufficient number of subjects to conclude that GAD as part of a diuretic renography protocol is an effective and simple technique that can help prevent unnecessary surgical procedures in pediatric patients.
随着肾积水早期检测率的提高，我们需要更好的方法来区分需要肾盂成形术的儿科患者和有短暂梗阻的患者。重力辅助引流（GAD）作为标准化利尿肾图检查方案的一部分，已被认为是一种区分患者的简单安全的方法。
对2004年1月至2007年3月期间89例有121个肾积水肾单位的受试者的肾脏扫描进行识别和分析。
在所有肾单位中，65%显示有梗阻。GAD操作导致8个肾单位有大量放射性示踪剂残留引流，12个肾单位有中度引流，40个肾单位在GAD操作后有一定改善。在有大量放射性示踪剂残留引流的8个肾单位中，只有2个进行了肾盂成形术。肾盂成形术后，9名儿童的达峰时间减半（T(1/2) Max）有所改善，13名儿童则无变化。
我们的研究由于其回顾性设计和描述性分析而受到限制，但纳入了足够数量的受试者以得出结论，即GAD作为利尿肾图检查方案的一部分是一种有效且简单的技术，可有助于防止儿科患者进行不必要的手术。
