MacNeily A E, Maizels M, Kaplan W E, Firlit C F, Conway J J
Division of Urology, Children's Memorial Hospital, Chicago, Illinois 60614.
J Urol. 1993 Aug;150(2 Pt 2):769-73. doi: 10.1016/s0022-5347(17)35610-0.
We reviewed 75 cases of isolated, unilateral pediatric ureteropelvic junction obstruction and 167 diuretic radionuclide renograms performed during the last 8 years. Differential function of the affected kidney was calculated using scintillation count data at 1 and 3 minutes, and the area under the renogram curve between 1 and 3 minutes. There was no significant difference among the 3 measures of per cent differential function for a given patient. Per cent differential function on the first renogram preoperatively neither declined as age at presentation advanced nor did it vary according to the clinical presentation. Similarly, the changes in postoperative per cent differential function were unaffected by the age at initial presentation, manner of presentation, occurrence of postoperative complications or the surgeon. These data do not support the concept that pyeloplasty for the isolated, unilateral ureteropelvic junction obstruction should be performed early to avert loss of renal function.
我们回顾了过去8年中75例孤立性、单侧小儿肾盂输尿管连接部梗阻病例以及167例利尿放射性核素肾图。利用1分钟和3分钟时的闪烁计数数据以及1至3分钟肾图曲线下的面积计算患肾的分肾功能。对于给定患者，这3种分肾功能测量方法之间无显著差异。术前首次肾图的分肾功能百分比既不随就诊年龄增加而下降，也不随临床表现而变化。同样，术后分肾功能百分比的变化不受初次就诊年龄、表现方式、术后并发症的发生或手术医生的影响。这些数据不支持对于孤立性、单侧肾盂输尿管连接部梗阻应早期行肾盂成形术以避免肾功能丧失这一观点。
