上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (6): 792-.doi: 10.3969/j.issn.1674-8115.2017.06.014

• 论著（临床研究） • 上一篇    下一篇

术后早期 PI-APD 在儿童 UPJO 手术疗效评估中的应用价值

姜大朋，陈周彤，耿红全，徐卯升，王礼国，徐国锋，林厚维，方晓亮，贺雷   

  1. 上海交通大学 医学院附属新华医院小儿外科，上海 200092
  • 出版日期:2017-06-28 发布日期:2017-07-05
  • 通讯作者: ?耿红全，电子信箱：ghongquan@hotmail.com
  • 作者简介:姜大朋（1978—），男，副主任医师，博士；电子信箱：jdp509@163.com
  • 基金资助:

     上海市科学技术委员会项目（14411950400,14411950408）；上海市教育委员会高峰高原学科建设计划（20152216）

Prospective value of early postoperative PI-APD in children with ureteropelvic junction obstruction

JIANG Da-peng, CHEN Zhou-tong, GENG Hong-quan, XU Mao-sheng, WANG Li-guo, XU Guo-feng, LIN Hou-wei, FANG Xiao-liang, HE Lei   

  1. Department of Pediatric Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Online:2017-06-28 Published:2017-07-05
  • Supported by:

    Foundation of Shanghai Municipal Committee of Science and Technology, 14411950400, 14411950408; Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20152216

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摘要：

 目的 · 分析术后3 个月PI-APD 对于儿童肾积水手术疗效评估的作用。方法 · 回顾性分析上海交通大学医学院附属新华医 院 2012 年 1 月—2015 年 11 月接受手术治疗的肾积水患儿资料。根据PI-APD 值将所有患儿分为3 组：PI-APD ≤ 19% 组、19%<PIAPD<40% 组及PI-APD  ≥ 40% 组。分析术后PI-APD 值与患肾分肾功能（DRF）及积水程度恢复的关系。结果 · 入组患儿360 例， 平均随访时间为 20 个月。术后 3 个月 PI-APD 值与患肾 DRF 恢复程度呈正相关 (r=0.631，P=0.000)。有 5 例患儿术后复发，其术后早 期 PI-APD 值均 <19%。结论 · PI-APD ≥ 40% 可以预示肾盂成形术后的良好结局；而 PI-APD ≤ 19% 则提示手术后应密切随访，及早 发现肾积水复发，避免患肾功能受损加重。PI-APD 是一种可行、简单且有效的评估肾积水术后效果的客观指标。

关键词: 肾积水, 肾盂成形术, 肾盂输尿管连接部梗阻, 肾盂前后径

Abstract:

Objective · To investigate the prospective value of early postoperative PI-APD in children with hydronephrosis.  Methods · Data of children with hydronephrosis who underwent pyeloplasty in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine between Jan 2012 to Nov 2015 was collected. PI-APD was divided into 3 categories ( ≤ 19%, 19%<PI-APD<40% and ≥ 40%). The relationship between PI-APD value and the degree of renal function (DRF) and dilation recovery after surgery was analyzed.  Results · There were 360 children with hydronephrosis. The median follow-up was 20 months. The PI-APD value (3 months after pyeloplasty) was positively correlated with the degree of DRF recovery (r=0.631, P=0.000). Five patients received redo-pyeloplasty. PI-APD of all these patients was <19%.  Conclusion · PI-APD is a new feasible ultrasound parameter in pyeloplasty followup. PI-APD ≥ 40% at the first post-operative visit predicts pyeloplasty success. PI-APD ≤ 19% indicates close follow-up after operation. PI-APD can also help select children at high risk for repeat intervention after pyeloplasty.

Key words:  hydronephrosis, pyeloplasty, ureteropelvic junction obstruction, anteroposterior diameter