急性上尿路梗阻性无尿的诊断

目的 提高急性上尿路梗阻性无尿的诊断水平。方法 对58例急性上尿路梗阻患者的临床表现、影像学检查结果和梗阻原因进行总结、分析。结果 临床表现为无尿58例、肾区疼痛41例、肾区叩击痛33例、高血压20例、血尿素氮和肌酐升高57例、高血钾8例。MRU、B超、x线（包括KUB、IVU、逆行肾盂造影）、CT、MRI等影像学检查为主要辅助检查。对上尿路梗阻的检出率，MRU为100％（25／25），B超为88％（50／57），CT／MRI为60％（6／10），X线为49％（19／39）；MRU、B超检出率显著高于X线和CT／MRI（P〈0．05）。对梗阻病因的检出率，MRU为88％（22／25），B超为46％（26／57），X线为46％（18／39），CT／MR为50％（5／10）；MRU检出率显著高于B超、X线和CT／MRI（P〈0．05）。梗阻病因为结石27例、肿瘤18例、输尿管狭窄4例、腹膜后纤维化3例、药物结晶2例、肾结核1例，不明原因3例。结论 影像学检查对急性上尿路梗阻性无尿的诊断具有重要价值，MRU、B超对梗阻的检出率较高，MRU在病因诊断方面具有优势。结石是最常见的上尿路梗阻病因，其次为肿瘤。     

急性上尿路梗阻并感染性休克的急症手术引流

目的:探讨急性上尿路梗阻并感染性休克的紧急处理措施.方法:对23例急性上尿路梗阻并感染性休克患者,在积极抗感染、纠正休克和电解质紊乱的同时,行急症引流手术.其中8例行急症开放手术解除梗阻内置双J管,3例输尿管镜下气压弹道碎石后置双J管内引流,2例在B超引导下行细针穿刺置管,5例经皮穿刺置管,5例单纯行双J管内引流.结果:23例术后情况均有不同程度的改善,19例在术后24～48h内体温基本恢复正常,休克得到纠正.结论:对急性上尿路梗阻并感染性休克的患者,在积极抗感染、纠正休克及电解质紊乱的同时,急症手术引流是首选的治疗方法.开放手术能一并解除病因.     

高草酸尿和输尿管梗阻对鼠肾小管上皮细胞凋亡的影响

目的探讨高草酸尿和输尿管梗阻(UUO)对鼠肾小管上皮细胞凋亡的影响. 方法雄性成年Wistar大鼠40只,随机分为4组,每组10只,A组为对照组,B组为高草酸尿组,C组为输尿管梗阻组,D组为高草酸尿并输尿管梗阻组.所有大鼠均在术后2周处死并取左肾,常规HE染色检测肾小管间质草酸盐结晶沉着情况;原位末端标记法(TUNEL)检测肾小管上皮细胞凋亡情况. 结果 B组和D组组织切片肾小管腔内可见明显草酸盐晶体沉着,A组和C组未见晶体沉着.计数5个高倍镜视野的细胞,A、B、C、D各组肾小管上皮细胞凋亡数分别为1.1±1.1,31.3±8.0,145.0±33.4,275.8±51;A组与各组相比差异均有显著性意义(P<0.001),B组与C组、D组相比差异有显著性意义(P<0.001),C组与D组相比差异亦有显著性意义(P<0.01). 结论高草酸尿可致肾小管间质草酸盐结晶沉着;完全性输尿管梗阻并高草酸尿使肾小管上皮细胞凋亡水平明显增高,且造成肾脏损害,输尿管梗阻是比高草酸尿更重要的促细胞凋亡因素.     

双侧上尿路结石梗阻并发急性肾功能衰竭(附40例报告)

目的：探讨双侧上尿路结石梗阻并发急性肾功能衰竭的诊断及治疗方法。方法：通过Ｂ超、ＫＵＢ、逆行插管造影检查明确诊断并通过肾、输尿管切开取石，肾穿刺造瘘，输尿管插管引流，ＥＳＷＬ达到治疗目的。结果：术后全部患者尿毒症症状减轻或消失，血尿素氮（ＢＵＮ）、血肌酐（Ｃｒ）均不同程度降低或恢复正常。结论：对双侧上尿路结石宜争取同期施行双侧手术，因并发严重感染或患者一般情况差而无法取石者则应及早作输尿管逆行插管     

肾动态显像定位诊断上尿路梗阻

静脉注射９９ｍＴｃＥＣ后立即动态采集双侧肾脏、输尿管及膀胱影像２０分钟，获得上尿路显像图、肾图曲线、输尿管曲线及高峰时间、高峰幅度、半排时间和２０分钟排泄率等定量参数。３００例受检病人中正常９３例，单纯显像异常９例，动态显像及肾功能、肾血流均异常１９８例，其中肾性梗阻１４２例，输尿管上段梗阻１９例、中段１６例、下段２１例。４０例病人同时作肾图，２０例作血清尿素氮和肌酐检查，４０例做Ｂ超、ＫＵＢ、ＩＶＵ检查，符合率分别为７３％、７５％和９０％。１０例经手术对照均符合诊断。结果表明：肾动态显像对于上尿路梗阻定位诊断、肾功能及肾血流判断具有较高价值，可常规用于临床。     

肾盂输尿管成形术及其辅助治疗

目的：探讨肾盂输尿管连接部（UPJ）梗阻的最佳治疗方法。方法报告63例（70例）UPJ梗阻的治疗情况,48侧行Anderson-Hynes肾盂成形术,其中8例巨大及重度肾积水者加作肾内翻折叠及肾固定术,6例行肾盂瓣输尿管成形术,5侧行Y－V成形术,11例行肾切除术,全部病例均放置输尿管支架引流,其中11例患儿应改良式双J管内引流。结果。48侧行Anderson-Hytes肾盂成形术者术后复查IVU显示肾盂明显缩小,肾功能改善,UPJ处蠕动良好,1例吻合口处狭窄,扩张后再次放置双J管8周后治愈。6侧行肾盂瓣成形术及5侧行Y－V成形术者术后复查肾积水有改善,但肾盂缩小不明显,UPJ处蠕动幅度、频率改善不明显。11侧应用改良双J管的患儿术后4周门诊拔管,均获治愈。停顿上以往外引流的18－20d缩短至6－7d.51例随访6个月5－年,1例吻合口处狭窄者扩张置管后治愈,余无复发。结论Anderson-Hynes肾盂成形术为最佳术式。巨大肾积水者行Anderson-Hynes肾盂成形术加肾内翻折叠及肾固定术不仅改善外观,更利于引流及功能恢复,改良式双J管可用于儿童患者内引流。     

Renal tubular apoptosis after complete ureteral obstruction in the presence of hyperoxaluria

Hyperoxaluria is a well-known cause of renal stone disease and in vitro studies have shown that oxalate crystals have a stimulatory effect on apoptosis of renal tubular epithelial cells. Total and partial ureteral obstruction also have an accelerating effect on apoptosis of renal tubular epithelial cells. The aim of the present study was to investigate the apoptotic effect of unilateral ureteral obstruction in the presence of hyperoxaluria on the rat kidney. Twenty-eight male Wistar rats were divided into four groups, with seven rats in each. The groups were named G1 (control), G2 (hyperoxaluric), G3 (obstructive) and G4 (hyperoxaluric + obstructive). G2 and G4 rats were given 1% ethylene glycol (a precursor for oxalates) in their drinking water. G1 and G2 rats underwent sham operation, while left proximal ureteral ligation with a 5-zero silk suture was performed on G3 and G4 animals. The rats were sacrificed 2 weeks after the operation; left nephrectomy was then performed. We searched for the apoptotic cells by direct immuno-peroxidase detection of digoxigenin-labeled genomic DNA. The mean ± SD values of the apoptotic cell count was 0.86 ± 0.90 in G1 and 4.33 ± 3.81 in G2. The values for G3 and G4 were 30.17 ± 16.85 and 302.67 ± 184.45, respectively. We found a statistically significant difference between all groups (P < 0.001). When compared with the control group (G1), the mean apoptotic cell count was fivefold that of G2 and 35- and 351-fold those of G3 and G4, respectively. Our study demonstrated that hyperoxaluria with complete ureteral obstruction induces an excessive level of apoptosis, which is responsible for renal damage, and that ureteral obstruction is a more important factor for apoptosis than hyperoxaluria. Considering these data, we also believe that research studies for medical preventive measures must be considered for patients with ureteral obstruction and/or hyperoxaluria. Received: 14 January 2000 / Accepted: 12 May 2000     

Bladder-neck incision for relief of obstruction after anti-incontinence surgery

Bladder-neck resection or incision in the female has been performed for many years, with variable results. As it has not been widely accepted in the past, the authors decided to review the indications and the surgical technique. From January to December 1986, ten such operations were performed on females with documented outlet obstruction related to previous anti-incontinence procedures. Bladder neck incisions rather than resections were performed, and the surgical technique is discussed. Also, the urological presentations of these patients including their investigations through urodynamics, are given. Bladder-neck incision is a valuable adjunct in the treatment of female bladder-neck obstruction.     

磁共振水成像对上尿路梗阻的诊断价值

目的:评价磁共振水成像(MRU)对泌尿系梗阻性疾病的临床诊断价值。方法:采用快速自旋回波重T2加权序列和脂肪抑制技术,对56例经B超和IVP怀疑上尿路梗阻患者,进行泌尿系冠状位扫描,将图像按最大强度投影法重建出MRU图像。结果:其中32例MRU均能清晰显示尿路梗阻的部位和肾盂积水,解剖结构清楚,可对梗阻作出定性诊断,并经手术和病理证实为尿路梗阻者。其中尿路结石16例,尿路先天性梗阻4例,输尿管炎性狭窄2例,移植肾输尿管狭窄2例,其他8例。余26例排除上尿路梗阻。结论:MRU是无创伤的检查方法,不接触射线,不需碘对比剂,诊断尿路梗阻性疾病定位、定性准确,尤其适用于因严重梗阻IVP显影不良的病例。     

急性上尿路结石梗阻的影像学分析

目的：探讨超声、腹部平片（ＫＵＢ）、静脉尿路造影（ＩＶＵ）对急性输尿管结石梗阻的诊断价值。方法：回顾性分析３５２例急性输尿管结石梗阻患者的Ｂ超、利尿性Ｂ超、ＫＵＢ、ＩＶＵ的诊断结果。结果：对肾积水的诊断,常规Ｂ超诊断率８３．２％（２９３／３５２）,而５９例可疑病例利尿性Ｂ超的诊断率７９．７％（４７／５９）,利用常规Ｂ超加利尿Ｂ超检查,对梗阻性肾积水的诊断率９６．６％（３４０／３５２）;对输尿管结石     

腹腔镜Anderson-Hynes肾盂离断成形27例报告

目的:对腹腔镜下肾盂离断成形术的临床应用价值进行评价。方法:回顾分析腹腔镜Anderson-Hynes肾盂离断成形27例的经验,对手术入路,临床效果及并发症进行分析。结果:26例手术成功,1例中转开放手术。腹腔入路18例手术时间(120±37)min,腹膜后(15±30)min(P<0.05)。术后肠道功能恢复时间腹腔入路(72±16)h,腹膜后(32±12)h(P<0.01)。出血量(100±40)ml,(80±35)ml(P>0.05);术后漏尿3/18,2/9(P>0.05)。术后随访时间2~23个月,26例患者腰痛消失,IVU显示肾盂输尿管连接部通畅,肾脏显影正常或明显改善。1例患者肾积水加重。结论:腹腔镜肾盂成形术是治疗肾盂输尿管连接部梗阻的理想术式。     

Tamm-Horsfall protein: are serum levels a marker for urinary tract obstruction?

Tamm-Horsfall protein (THP) has been found in the renal interstitium in patients with obstructive uropathy. The aim of this study was to investigate whether serum concentrations of THP could serve as a screening test for urinary tract obstruction. The presence of THP in normal human serum was confirmed by sodium dodecyl sulphate polyacrylamide gel electrophoresis and Western blotting. A specific enzyme immunoassay was then used to measure the serum concentration of THP. Serum THP concentrations were estimated in a cross-sectional study of a group of 23 patients who had technetium-99m-diethylenetriaminepenta-acetic acid (DTPA) nuclear urinary excretion studies to define urinary tract obstruction, and in longitudinal studies in 2 patients who developed acute bilateral ureteric obstruction following operations for ureteric reimplantation. The subjects with DTPA-proven urinary tract obstruction had higher concentrations of serum THP (n=10, median = 43.9 ng/ml, range 10.4–152.1 ng/ml) than those who did not have obstruction (n=13, median = 9.6 ng/ml, range 1.26–61.9 ng/ml). While this difference was significant (P<0.01, Mann-Whitney U test), 6 of the 10 patients with obstruction had serum THP concentrations within the range of those patients without obstruction. The patients who developed acute bilateral ureteric obstruction both had increases in serum THP concentrations with obstruction and decreases in serum THP concentrations following relief of obstruction. These changes paralleled those in serum creatinine. The studies indicate that urinary tract obstruction results in increases in serum THP concentrations but these changes are not sufficient in magnitude to allow screening of children for urinary tract obstruction.     

Emerging roles of obstruction and mutations in renal malformations

In this short review I will highlight some of the ”molecular lesions” that occur in patients with malformations of the urinary tract in terms of: (1) aberrant gene expression in dysplastic and obstructed kidneys and (2) the effects of mutations and genetic polymorphisms on renal growth and response to injury. It is suggested that the prenatal obstruction of urinary flow transduces a signal which elicits a proliferative response in existing metanephric epithelia, with a concomitant block in new nephron formation and apoptosis of precursor cells. Understanding these processes may lead to the therapeutic modulation of disease. Secondly, I will review possible genetic influences in the generation of isolated (non-syndromic) renal malformations. In this respect, primary vesicoureteric reflux represents numerically the most important disorder, and the discovery of disease loci should facilitate early diagnosis and identification of asymptomatic carriers. It is possible that the apparent variable penetrance and expression of some familial renal malformations are the result of the action of modifying genes which act during kidney development or even after the nephrogenic period. Received January 9, 1998; accepted February 11, 1998     

急性梗阻性自发性尿外渗的临床诊治

目的：提高急性梗阻性自发性尿外渗的诊断和治疗水平。方法：回顾性分析9例急性梗阻性自发性尿外渗患者的临床资料,并结合文献探讨其诊断和治疗方法。结果：患者多以肾绞痛发病,逐渐发展成持续或不典型疼痛,并向腹部蔓延,患侧肾区有明显叩击痛。B超、尿路造影及CT检查对诊断有肯定价值。结论：本病为尿路梗阻后继发的临床综合症,早期诊断较为困难,确诊主要依靠影像学检查。尽早解除尿路梗阻是本病治疗的原则。     

Genetic and developmental basis for urinary tract obstruction

Urinary tract obstruction results in obstructive nephropathy and uropathy. It is the most frequent cause of renal failure in infants and children. In the past two decades studies of transgenic models and humans have greatly enhanced our understanding of the genetic factors and developmental processes important in urinary tract obstruction. The emerging picture is that development of the urinary tract requires precise integration of a variety of progenitor cell populations of different embryonic origins. Such integration is controlled by an intricate signaling network that undergoes dynamic changes as the embryo develops. Most congenital forms of urinary tract obstruction result from the disruption of diverse factors and genetic pathways involved in these processes, especially in the morphogenesis of the urinary conduit or the functional aspects of the pyeloureteral peristaltic machinery.     

多沙唑嗪对兔膀胱出口部分梗阻致膀胱顺应性减低的影响

目的 探讨多沙唑嗪对兔膀胱出口部分梗阻后膀胱顺应性改变的影响.方法 成年雄性新西兰兔40只随机分为4组,每组10只,A组为假手术对照组,B组为膀胱出口部分梗阻组,C组为膀胱出口部分梗阻后口服多沙唑嗪组,D组为假手术后给予多沙唑嗪组.各组于14周行尿动力学检测,检测完成后处死并留取膀胱标本,行膀胱称重.结果 4组膀胱标本质量分别为(3.2±0.9)、(14.1±2.3)、(5.0±2.0)、(2.9±0.5)g;B、C组均高于A、D组,B组高于C组,差异均有统计学意义(P＜0.01);A、D组间比较差异无统计学意义(P＞0.05).4组逼尿肌漏尿点压分别为(10.2±2.5)、(18.8±6.1)、(13.5±4.7)、(11.6±3.6)cm H2O(1 cm H2O=0.098 kPa),B组高于A、D组,差异有统计学意义(P＜0.01),且高于C组,差异有统计学意义(P＜0.05);A、C、D组间差异无统计学意义(P＞0.05).膀胱顺应性分别为(2.86±0.56)、(1.22±0.39)、(4.25±2.19)、(2.90±0.53)ml/cm H2O,B组与A、D组相比明显下降,差异有统计学意义(P＜0.01);C组高于A、D组,差异有统计学意义(P＜0.05);A、D组间差异无统计学意义(P＞0.05).结论膀胱出口部分梗阻后早期应用多沙唑嗪治疗能够延迟梗阻对膀胱顺应性的损害,保护膀胱储尿功能.

Abstract：

Objective To explore the effect of doxazosin on rabbit bladder compliance after partial bladder outlet obstruction. Methods A total of 40 male New Zealand white rabbits were randomized into 4 groups, with 10 rabbits in each group. Partial bladder outlet obstruction was established in groups B and C, while groups A and D underwent the same operation but without partial bladder outlet obstruction. On the day after the operation, groups C and D received oral administration of doxazosin. After 14 weeks, urodynamic examinations were carried out in all groups, and the bladder was weighted after cystectomy. Results Bladder weight was (3.2±0.9) g in group A, (14.1±2.3) g in group B, (5.0±2.0) in group C,and (2.9±0.5) g in group D. The bladder weight in groups B and C increased significantly compared to groups A and D (P＜0.01), group B increased significantly over group C (P＜0.01), and there was no significant difference between groups A and D (P＞0.05).The detrusor leak point pressure was (10.2±2.5) cm H2O in group A, (18.8±6.1) cm H2O in group B, (13.5±4.7) cm H2O in group C,and (11.6±3.6) cm H2O in group D. The detrusor leak point pressure in group B was significantly higher than group A, group D (P＜0.01) and group C (P＜0.05). There was no significant difference between group A, group C and group D (P＞0.05). The bladder compliance was (2.86±0.56) ml/cm H2O in group A, (1.22±0.39) ml/cm H2O in group B, (4.25±2.19) ml/cm H2O in group C,and (2.90±0.53) ml/cm H2O in group D. The bladder compliance was significantly decreased in group B compared to groups A and D (P＜0.01). Bladder compliance in group C was significantly higher than in groups A and D (P＜0.05), and there was no significant difference between group A and group D (P＞0.05). Conclusion Early use of doxazosin can delay the occurrence of lower bladder compliance after partial bladder outlet obstruction, thus protecting the storage function of bladder.     

Bladder development following bladder outlet obstruction in fetal lambs: optimal timing of fetal therapy

Background

Lower urinary tract obstruction causes both renal failure and bladder dysfunction after birth. This study examined the early bladder wall changes after creating an obstructive uropathy focusing on bladder wall thickness and muscle integrity.

Methods

We created obstructive uropathy in fetal lambs at 60 days' gestation, ligating the urethra and urachus. The fetuses (n = 28) were delivered at 48 hours and 3, 4, 5, 7, and 14 days after obstruction and at term (145 days' gestation). Sham-operated lambs were used as controls (n = 20). Histology samples were stained using α-smooth muscle actin) immunohistochemistry and also hematoxylin-eosin, Masson trichrome, and colloidal Fe stain.

Results

The bladder wall initially expanded and stretched. By day 4, the bladder wall became thicker. Histologically, the bladder in obstructed lambs demonstrated a prominent submucosal fibrotic change by 7 days. The mean bladder wall thickness at 14 days after obstruction was thicker than controls, and fibrosis was prominent.

Conclusion

The initial changes in the bladder wall were expansion of the muscle component followed by fibrosis. The bladder wall thickness dramatically increased 4 to 7 days after obstruction. We conclude that shunting operations to preserve bladder function may be needed earlier than expected.     

Obstructive ureterocele—an ongoing challenge

Ureterocele is a cystic dilatation of the intravesical ureter that is most commonly observed in females and children, and usually affects the upper moiety of a complete pyeloureteral duplication. According to their position, ureteroceles are divided into intravesical, when the ureterocele is completely contained inside the bladder, and extravesical when part of the cyst extends to the urethra or bladder neck. Most ureteroceles are diagnosed in utero or immediately after birth during an echographic screening of renal malformations. Severe, febrile urinary tract infection is the most common postnatal presentation of ureteroceles, but they may, rarely, prolapse and acutely obstruct the bladder outlet. Once an ureterocele is identified sonographically, a voiding cystourethrogram to detect vesicoureteral reflux (VUR) and a 99m-technetium dimercapto-succinic acid renal scan to evaluate the function of the different portions of the kidney are mandatory. VUR in the lower pole is observed in 50% of cases and in the contralateral kidney in 25%. Simple endoscopic puncture of the ureterocele has recently been advocated as an emergency therapy for infected or obstructing ureteroceles and as an elective therapy for intravesical ureteroceles. The rate of additional surgery after elective endoscopic puncture of an orthotopic ureterocele ranges from 7 to 23%. Treatment of ectopic ureteroceles is more challenging and both endoscopic puncture and upper pole partial nephrectomy frequently require additional surgery at the bladder level. The reoperation rate after endoscopic treatment varies from 48 to 100%. It is 15 to 20% after upper pole partial nephrectomy if VUR was absent before the operation, but is as high as 50–100% when VUR was present. Thus, endoscopic incision is appropriate as an emergency treatment or when dealing with a completely intravesical ureterocele. Upper pole partial nephrectomy is the elective treatment for an ectopic ureterocele without preoperative VUR. In an ectopic ureterocele with VUR, no matter which type of primary therapy has been chosen, a secondary procedure at the bladder level, involving ureterocele removal and reimplantation of the ureter(s), should be anticipated.     

Relative renal function does not improve after relieving chronic renal obstruction

Study Type – Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Technetium‐99m MAG3 renography can be used to quantify relative renal function (RRF). Deterioration of renal function occurs with chronic obstruction. Small studies have previously shown that RRF is not improved in adult patients after pyeloplasty. Some studies have suggested that patients with higher preoperative RRF are more likely to improve. To our knowledge, these data represent the largest review of cases related to this subject. This study verifies past studies' assertions that RRF does not improve after relief of chronic renal obstruction. Using multivariable analysis, we identify lower age and lower preoperative RRF as predictors of >7% improvement in RRF. These data suggest that the aim of relieving obstruction should be to maintain RRF and alleviate symptoms, but not to seek improvement in overall renal function.

OBJECTIVE

• ? To determine the change in relative renal function (RRF) after relief of chronic obstruction in adults.

PATIENTS AND METHODS

• ? We retrospectively identified 85 adult patients who underwent scintigraphic diuretic renography before and after an intervention to relieve chronic unilateral renal obstruction.
• ? Patients were stratified into groups of low (<20%), medium (20‐40%) and high (>40%) preoperative RRF in the obstructed kidney. Each group was assessed for change in RRF after relief of obstruction.
• ? We performed multivariable logistic regression analysis to determine whether age and pre‐procedural RRF predicted a >7% improvement in RRF, controlling for medical comorbidities and type of obstruction.

RESULTS

• ? The mean (sd ) patient age was 43.6 (16.8) years and 66% of patients were female.
• ? The mean (sd ) pre‐ and postoperative RRF values were not significantly different (37.6 [12.3] % vs 38.4 [13.6] %; P = 0.31).
• ? Patients stratified by low, medium and high preoperative function showed no significant change in postoperative RRF (P = 0.53, 0.39 and 0.77, respectively).
• ? In multivariable logistic regression analysis, younger age (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.83–0.98) and lower preoperative RRF (OR 0.90, 95% CI 0.83–0.97) predicted improvement in RRF of >7%, after adjustment.

CONCLUSIONS

• ? RRF does not significantly increase after relief of chronic obstruction.
• ? The goals of relieving chronic renal obstruction should be to maintain renal function and relieve symptoms, but not to regain renal function.

     

急性单侧上尿路梗阻肾脏与肾周改变的多排螺旋CT特点及其内在联系

目的分析急性单侧上尿路梗阻患侧肾脏及肾周改变的多排螺旋CT（MDCT）表现特点,并探讨两者的内在联系。 方法收集南海医院2015年至2017年间376例因结石所致急性单侧上尿路梗阻病例,所有病例均行MDCT扫描。回顾分析其患侧肾脏及肾周改变的MDCT的表现,采用Spearman秩相关系数来衡量两变量之间相关关系的强弱。 结果肾周改变分级与肾积水程度低度相关（R_s=0.194,P<0.001）;与肾实质密度减低中度相关（R_s=0.387,P<0.001）;与肾体积增大中度相关（R_s=0.545,P<0.001）。 结论通过分析急性单侧上尿路梗阻时肾脏及肾周间隙MDCT表现特点,能了解其内在联系,肾周改变的严重程度与肾积水程度和肾肿胀程度密切相关。