论文部分内容阅读
目的应用99Tcm-DTPA核素肾动态显像观察单侧急性上尿路梗阻不同时期肾功能的变化及与梗阻解除后恢复状况的比较。方法采用动物实验模型:健康家兔24只,手术制作左侧输尿管完全梗阻模型,术前及术后1周均行基础核素肾动态显像。然后,选择梗阻后1、3周、5~7周及8周不同时间点,解除梗阻,4周后行99Tcm-DTPA利尿肾动态显像(以下简称利尿显像)。结果于左肾梗阻后1、3周、5~7周或8周以上分别解除梗阻,4周观察患侧肾功能的恢复情况,利尿显像示梗阻1~3周解除梗阻,观察4周后左肾肾小球滤过率(GFR),摄取率,基本恢复,与解除梗阻前比较差异有统计学意义,峰时,T1/2恢复缓慢,与解除梗阻前差异无统计学意义。梗阻5~7周后解除梗阻,观察4周后左肾GFR,摄取率部分恢复,与解除梗阻前比较差异无统计学意义。梗阻8周以上再解除肾功能无法恢复。结论急性上尿路完全梗阻后肾功能降低迅速,以早期最为显著,早期梗阻解除后肾功能恢复明显。晚期梗阻,即使解除梗阻肾功能也不易恢复。核素肾动态显像方法简便,能显示早期肾功能受损及解除梗阻后患肾的恢复情况,是评价肾功能恢复的有效手段。
Objective To observe the changes of renal function at different stages of unilateral acute upper urinary tract obstruction and the comparison with post-obstruction recovery by 99Tcm-DTPA radionuclide dynamic imaging. Methods The experimental model of the animal was established: 24 healthy rabbits were enrolled in this study. The left ureter obstruction model was surgically produced and the renal radionuclide imaging was performed preoperatively and 1 week after surgery. Then, at 1, 3 weeks, 5 to 7 weeks and 8 weeks after obstruction, the obstruction was removed and the 99Tcm-DTPA diuretic dynamic imaging (hereinafter referred to as diuretic imaging) was performed 4 weeks later. Results One, three weeks, five to seven weeks or more than 8 weeks after the left renal obstruction were respectively obstructed, and the recovery of ipsilateral renal function was observed in 4 weeks. The diuretic imaging showed obstruction for 1 to 3 weeks to relieve the obstruction. After 4 weeks The left renal glomerular filtration rate (GFR), uptake rate, basic recovery, and the release of obstruction before the difference was statistically significant peak, T1 / 2 recovery is slow, and the lifting of obstruction before the difference was not statistically significant. After 5 to 7 weeks of obstruction, the obstruction was relieved. After 4 weeks of observation, the GFR of the left kidney was recovered partially and the difference was not statistically different from that before the obstruction was relieved. Obstruction more than 8 weeks and then lift the renal function can not be restored. Conclusions The renal function decreased rapidly after complete obstruction of upper urinary tract, which was the most obvious in early stage. The recovery of renal function was obvious after the early obstruction was relieved. Late obstruction, even if the lifting of obstructive renal function is not easy to recover. Radionuclide renal dynamic imaging method is simple, can show the early renal impairment and renal recovery after the lifting of the obstruction, is to evaluate the effective means of renal function recovery.