Tsuboi N, Yajima I, Hasegawa J, Hirasawa S, Oki M, Sugizawa Y, Nishimura T, Akimoto M
Department of Urology, Nippon Medical School.
Hinyokika Kiyo. 1988 Oct;34(10):1717-21.
The influence of percutaneous nephrolithotomy (PNL) on renal function was evaluated by 99m-Tc-DTPA renoscintigraphy. The renoscintigram was recorded and regions of interest of both kidneys (R) and background (BKG) were settled. Renal uptake ratio was calculated by the following formula. Renal uptake ratio = (formula; see text). The renal uptake ratio of 50 patients were compared before and up to 6 months after PNL. Most cases showed an increase or no change in post-PNL renal uptake ratio in operated kidney. Five cases (10%) showed decreased renal uptake ratio of post-PNL. No risk factors for the renal damage caused by PNL such as age, sex, stone size, number of nephrostomy and course of PNL were detected when compared with increased or no change groups. In cases of complete staghorn calculi in the decreased renal uptake ratio group, compensatory hypertrophy of contralateral kidney PNL course might occur, and the function of the operated kidney might not have recovered. More during cases and longer follow-up is necessary for the recovery of renal function.
采用99m锝-二乙三胺五乙酸（99m-Tc-DTPA）肾动态显像评估经皮肾镜取石术（PNL）对肾功能的影响。记录肾动态显像，并设定双肾的感兴趣区（R）和本底（BKG）。通过以下公式计算肾脏摄取率。肾脏摄取率=（公式；见正文）。比较了50例患者PNL术前及术后6个月内的肾脏摄取率。大多数病例显示，手术侧肾脏PNL术后的肾脏摄取率升高或无变化。5例（10%）患者PNL术后肾脏摄取率降低。与摄取率升高或无变化的组相比，未检测到诸如年龄、性别、结石大小、肾造瘘次数及PNL手术过程等导致PNL肾损伤的危险因素。在肾脏摄取率降低组中，若为完全鹿角形结石，PNL手术过程中对侧肾脏可能会发生代偿性肥大，且手术侧肾脏功能可能尚未恢复。需要更多病例及更长时间的随访来观察肾功能的恢复情况。
