| Objective:To explore the role of quantitative indicators :glomerular filtration rate, differential renal function and perfusion index in the evaluation of renal function in patients with upper urinary tract obstruction after operation Methods:This study retrospectively analyzed 34 patients with upper urinary tract obstruction and have diuretic renal dynamic imaging in the Department of nuclear medicine, the second hospital of Shanxi Medical University from March 2012 to January 2016, with a total of 62cases(2 of 32 patients had unilateral nephrectomy).Male 16 cases, female 18 cases, mean age 40.53 + 14.36 years old(16 ~ 72Y).There were 33 cases of unilateral hydrocephalus, 1cases of bilateral hydrocephalus, 2 cases of unilateral renal hydrocephalus after surgery for2 times diuretic renal dynamic imaging, there are 37 cases of kidney totally.All the selected patients were confirmed by B ultrasound or other imaging examinations and underwent various surgical procedures for the removal of obstruction.It was divided into 2 groups according to the time of diuretic renal dynamic imaging :Group 1≤3M,Group 2>3M,Which the Group 1have 11 cases, Group 2 26 cases. In order to facilitate the processing and analysis of the result data,The two groups of patients were divided into subgroups according to the GFR DRF.According to the glomerular filtration rate is divided into 30 ≤ GFR <45[ml/(min1.73m2)] and GFR < 30 [ml/(min- 1.73m2)];according to the differential renal function is divided into DRF≥30%, DRF < 30%. After the surgery, the effect of the kidneywas judged by the change of the index before and after operation as the reference standard of 5%,, postoperative index is greater than or equal to 5% of renal function improved(increased), postoperative index < + 5% for no change(constant), postoperative index >-5%above for the deterioration(reducing) and other three kinds of situation.SPSS17.0 statistics software was used to analyze.The data were expressed as mean + standard deviation(x +s),Paired t test was used for counting data;Chi square test was used for measurement data,Correlation analysis using bivariate correlation analysis. P<0.05 that the difference was statistically significant.Results:The recovery time ≤3M of renal improvement, no change, deterioration distribution respectively63.4%(7 /11),18.2%(2/11),18.2%(2/11); recovery time was >3M of renal improved,no,change,deterioration,distribution,respectively,53.9%(14/26),11.5%(3/26),34.6%(9/26),between the two without significant difference(χ2=1.201,P>0.05)Recovery time was ≤3M of 11 patients, grouped according to the GFR, deterioration in 2 cases, in accordance with the DRF group, 4 cases were deteriorated, after which 4cases included 2 cases of anterior, recovery time was >3M of suffering from kidney,grouped according to the GFR, worsened in 9 cases, in accordance with the DRF group, 8cases of deterioration, the 9 cases involved in 8 cases, the overall deterioration of the proportion for 35.14%(13/37),and no improvement for 54.05%(20/37).Differential renal function and perfusion index were have a good relation with glomerular filtration rate(r DRF=0.951,P<0.01;r PI=-0.867,P<0.01).Conclusions:After removing the obstruction of patients with renal water, it is recommended to review the routine in March, especially in the GFR < 30[ml/(1.73m2min)] of the kidney,should be re intervention in advance to prevent delays and affect the recovery of renal function.Before and after the operation of hydronephrosis in patients can be selected GFR,DRF and PI and other indicators were evaluated relation and the correlation of renal function and GFR were higher than those in PI, therefore, in accordance with the renal function evaluation value ranking for GFR>DRF>PI. |
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