| Objective: The researchers were inpatients whose no function renal with obstructive severe hydronephrosis were assassing by 99mTc-DTPA renal function dynamic imaging,renal function grouping according to the urine volume after Percutaneous Nephrostomy(PCN),comparative analysis the urine volume and Glomerular Filtration Rate(GFR)of each renal function group,the aim of this work is to explore the accuracy and sensitivity of 99mTc-DTPA renal function dynamic imaging in the assessment of no renal function with stone obstructive severe hydronephrosis.Methods: 1.Retrospective analysis the clinical data of hospitalized patients with obstructive severe hydronephrosis who were visiting the Affiliated Hospital of Youjiang Medical College for Nationalities from September 2013 to December 2017,and there were 27 subjects meeting the inclusion and exclusion criteria;2.The 27 subjects were performed 99mTc-DTPA renal function dynamic imaging after admission,as well as urinary ultrasound or computed tomography(CT),clearing diagnosis no function renal with obstructive severe hydronephrosis,and blood routine,coagulation,liver and kidney function,urine routine,chest X-ray to excluded other diseases.All the 27 subjects were underwent the first stage of PCN,and register daily drainage tube patency,drainage volume and urine color.3.Collecting statistical data of the drainage volume,from the second day after PCN,calculating and grouping the average drainage volume of the unilateral kidney from 1 to 7 days.No renal function: the average renal drainage volume was <200 ml/24 h for unilateral renal function;renal function-improved: average renal drain volume was 200~600 ml/24 h for unilateral renal function group;recoverable renal function group: the average renal drainage volume was >600 ml/24 h.By retrospection analysis average drainage volume of the unilateral kidney,to explore the accuracy and sensitivity of 99mTc-DTPA renal function dynamic imaging in the assessment of no renal function with obstructive severe hydronephrosis.Results: 1.There were 27 patients,a total of 31 people with no renal function included in the study,the male patients were 14,a total of 17 kidney,13 female patients with 14 kidney,of which 3 of male patients and 1 of female patients was double kidney without function.No renal function group: 10 kidney without function(32.26%),renal function Improvement Group: 5 kidney without function(16.13%);recoverable kidney Function Group: 16 kidney without function(51.61%).The age range of the subjects was 12~75 years,with an average age of 50.22±13.98 years.2.The mean drainage urine volume in the no renal function group was 94.83± 20.71 ml/24 h,the average drainage urine volume in the renal function improvement group was 363.84± 62.42 ml/24 h,and the mean draining urine volume in the recoverable renal function group was 1537.24± 229.16 ml/24 h.3.The GFR values of the subjects in each group obeyed the normal distribution(P>0.05),and the GFR in the no renal function group was 7.71± 0.64 ml/min,the GFR in the renal function improvement group was 5.20± 1.25 ml/min,and the GFR in the recoverable renal function group was 4.83±0.79 ml/min.The variance among the groups was homogeneous(P>0.05),and the difference between the groups was statistically significant(P<0.05),and the difference between the groups was statistically significant(P<0.05).The LSD-t test analysis of each group's pairwise comparison showed a significant difference between the nonfunctional group and the recoverable renal function group(P<0.05),while there was no significant difference between the renal function improved group and the no renal function group or the recoverable renal function group(P>0.05).Conclusion: 1.99mTc-DTPA renal function dynamic imaging was less accurate in the evaluation of no renal function with stone obstructive severe hydronephrosis,and it cannot be diagnosed as dysfunction and resection alone.2.99mTc-DTPA renal function dynamic imaging was poor sensitivity when GFR<10 ml/min,which was cannot reflect the real renal function changes of the kidney with stone obstructive severe hydronephrosis.3.After the first stage of PCN,comparing to 99mTc-DTPA renal function dynamic imaging,drainage urine volume can accurately,sensitively and intuitively reflect the renal function with obstructive severe hydronephrosis. |
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