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目的:探讨核素肾动态显像法测定肾小球滤过率(GFR)在老年肾癌患者中的临床应用价值。方法:回顾性分析30例老年肾癌患者术前及术后1个月应用~(99)锝-二乙三胺五乙酸(~(99)TC-DTPA)肾动态显像法测定GFR的结果,对健侧肾及术侧残肾进行手术前后的比较,观察其代偿性变化。结果:肾根治性切除组术后健侧肾GFR为(57.6±11.8)ml/min,较术前健侧肾(41.2±7.4)ml/min增加39.8%,但与术前双肾GFR(74.9±12.8)ml/min比较则下降了23.1%。肾部分切除组术侧残肾GFR为(27.8±4.8)ml/min,较术前(36.5±6.4)ml/min减少23.9%,健侧肾GFR手术前后比较差异无统计学意义。结论:采用核素肾动态显像法测定GFR在评估老年肾癌患者分肾功能、选择手术方式及监测术后肾功能方面有重要临床价值。
Objective: To investigate the clinical value of radionuclide renal dynamic imaging in the determination of glomerular filtration rate (GFR) in elderly patients with renal cell carcinoma. Methods: The results of renal dynamic imaging of ~ (99) technetium-diethylenetriamine pentaacetic acid (~ (99) TC-DTPA) were measured in 30 elderly patients with renal cell carcinoma before and one month after surgery , The contralateral kidney and residual kidney surgery before and after the comparison to observe the compensatory changes. Results: The GFR of contralateral kidney in radical nephrectomy group was (57.6 ± 11.8) ml / min, which was 39.8% higher than that in preoperative contralateral kidney (41.2 ± 7.4) ml / min, ± 12.8) ml / min compared to a decrease of 23.1%. The GFR was (27.8 ± 4.8) ml / min in the renal part resection group, which was 23.9% lower than that before the operation (36.5 ± 6.4) ml / min. There was no significant difference in the GFR before and after the kidney transplantation. Conclusion: The determination of GFR by radionuclide renal dynamic imaging has important clinical value in evaluating the renal function, selecting surgical methods and monitoring postoperative renal function in elderly patients with renal cell carcinoma.