Poulsen E U, Jørgensen T M, Taagehøj-Jensen F, Djurhuus J C
Department of Urology K, Aarhus Municipal Hospital, Denmark.
Scand J Urol Nephrol. 1987;21(3):213-7. doi: 10.3109/00365598709180324.
35 patients, age 3-69 years, mean 27, with pyeloureteric junction obstruction and hydronephrosis on I.V.P. were operated by Anderson-Hynes pyeloplasty. Prior to operation all patients were further investigated by renal scintigraphy. The postoperative follow-up consisted of a second I.V.P. after 12 months and repeated scintigraphies once or twice yearly. Mean follow-up time was 28 months. Thirty-three % of the patients with a decreased 2 min uptake fraction preoperatively had a significant increase in renal function after surgery. This increase was seen within the first 12 months. The rate of increase was greatest in patients below 30 years. Older patients only showed stabilized function. None of the patients had significant decrease in renal function. There was no correlation between the change in renal function and change in the I.V.P. It is concluded that an active surgical attitude in hydronephrosis is justified. Furthermore, follow-up after reconstruction could be limited to a renography 6 and 12 months postoperatively in otherwise asymptomatic cases with stable or improved uptake fraction.
35例年龄在3至69岁（平均27岁）、经静脉肾盂造影显示肾盂输尿管连接处梗阻并伴有肾积水的患者接受了安德森-海因斯肾盂成形术。术前，所有患者均接受了肾脏闪烁扫描进一步检查。术后随访包括术后12个月进行第二次静脉肾盂造影，以及每年进行一到两次重复闪烁扫描。平均随访时间为28个月。术前2分钟摄取分数降低的患者中，33%术后肾功能有显著改善。这种改善在术后前12个月内出现。30岁以下患者的改善率最高。老年患者仅显示功能稳定。所有患者的肾功能均无显著下降。肾功能变化与静脉肾盂造影变化之间无相关性。结论是，对肾积水采取积极的手术态度是合理的。此外，对于摄取分数稳定或改善且无症状的病例，重建术后的随访可限于术后6个月和12个月进行肾图检查。
