CAJ | 학술논문

目的：探讨分肾功能（DRF）在成人单侧先天性肾盂输尿管连接部梗阻（UPJO）手术前后肾功能评价中的价值。方法选取2008年1月-2012年12月诊断为成人单侧先天性UPJO患者32例，术前利用肾动态显像测定分肾功能，将患者分为3组（ DRF≥40％I组10例，30％≤DRF＜40％II组14例，DRF＜30％III组8例）。术后6个月再次复查并与手术前进行比较。结果术前患肾DRF≥40％（I组），术后患肾功能平均提高（2．18±3．25）％，与术前相比差异无显著性意义（P＝0．463）；术前患肾30％≤DRF＜40％（II组），术后患肾DRF平均提高（11．37±3．82）％，与术前相比差异有显著性意义（P＝0．000）；DRF＜30％（III组）术前术后平均DRF分别为（22．18±2．73）％和（24．35±3．56）％，差异无显著性意义（P＞0．05）。结论 DRF能预测UPJO解除梗阻后肾功能的恢复情况。30％≤DRF＜40％患者术后肾功明显改善，DRF≥40％与DRF＜30％患者术后肾功能无明显改善。
목적：탐토분신공능（DRF）재성인단측선천성신우수뇨관련접부경조（UPJO）수술전후신공능평개중적개치。방법선취2008년1월-2012년12월진단위성인단측선천성UPJO환자32례，술전이용신동태현상측정분신공능，장환자분위3조（ DRF≥40％I조10례，30％≤DRF＜40％II조14례，DRF＜30％III조8례）。술후6개월재차복사병여수술전진행비교。결과술전환신DRF≥40％（I조），술후환신공능평균제고（2．18±3．25）％，여술전상비차이무현저성의의（P＝0．463）；술전환신30％≤DRF＜40％（II조），술후환신DRF평균제고（11．37±3．82）％，여술전상비차이유현저성의의（P＝0．000）；DRF＜30％（III조）술전술후평균DRF분별위（22．18±2．73）％화（24．35±3．56）％，차이무현저성의의（P＞0．05）。결론 DRF능예측UPJO해제경조후신공능적회복정황。30％≤DRF＜40％환자술후신공명현개선，DRF≥40％여DRF＜30％환자술후신공능무명현개선。
Objective To discuss the value of differential renal function in the assessment of renal function before and after adult unilateral congenital ureteropelvic junction obstruction pyeloplasty .Methods From January 2008 to December 2012 , 32 cases with adult unilateral congenital ureteropelvic junction obstruction were selected , whose differential renal function ( DRF) was measured preoperatively by Renal dynamic imaging .The patients were divided into three groups according to the preoperative DRF:Group I ( n=10 ) , DRF≥40%; Group II ( n=14 ) , 30%≤DRF<40%; Group III ( n=8 ) , DRF<30%.The patients’ DRF were re-examined 6 months post-operation and were compared to those of pre -opera-tion.Results For patients who had preoperative DRF ≥40%(Group I), postoperative DRF improved (2.18 ±3.25)%on average although the difference is not statistically significant (P=0.463).For patients who had preoperative DRF≥30%and <40%(Group II), the mean postoperative DRF improved (11.37 ±3.82)%, significantly different from the preoperative DRF (P=0.000).For patients who had preoperative DRF <30%(Group III), the preoperative DRF and postoperative DRF were (22.18 ±2.73)%and (24.35 ±3.56)%, respectively (P>0.05).Conclusion DRF can pre-dict the recovery of renal function after pyeloplasty .The patients with 30%≤DRF<40%have significantly improved renal function after surgery;whereas , the patients with DRF≥40% or DRF<30% have no significant renal function improve-ment .