^99Tc^m—DTPA肾动态显像对上尿路结石症的临床价值

目的探讨^99Tc^m-DTPA（二乙烯三胺五醋酸）肾动态显像对上尿路结石患者诊断和治疗的临床价值。方法回顾性分析因上尿路结石行^99Tc^m-DTPA肾动态显像且随访资料完整的患者49例，患病肾脏共61只，根据首次肾动态显像检查患肾的功能状况进行分组，统计患肾的肾小球滤过率（GFR）、20min排泄率（R20）。结果^99Tc^m-DTPA肾动态显像共提示上尿路梗阻或不完全梗阻肾脏57只，诊断阳性率为93．4％（57／61），解除梗阻后3个月肾功能明显改善但程度不等，解除梗阻前肾功能重度受损者其GFR和R20恢复差。13例（13／49）肾功能重度受损患者进行了患侧。肾脏摘除手术。结论上尿路梗阻患者及时进行肾动态显像检查，对临床治疗方法选择具有明显的指导意义。早期了解患肾功能并及时解除梗阻，可以最大限度地恢复和保留患肾功能，避免最终可能导致的患肾摘除.

The clinical value of ^99Tc^m -DTPA renal dynamic hnaging in upper urinary tract calculus

Objective To evaluate the clinical value of ^99Tc^m - DTPA renal dynamic imaging in upper urinary tract calculus. Methods Forty - nine patients with upper urinary tract calculus were examined by ^99Tc^m - DTPA renal dynamic imaging. Sixty - one kidneys were diagnosed and divided into four groups according to their renal function. In each case, all the items including glomerular filtration rate （GFR） and excretion rate at 20 min （R20） were observed. Results Fifty - seven kidneys were diagnosed light or serious upper urinary obstruction. The rate was 93.4% （57/61）. Their renal functions were improved in different degree three months after upper urinary obstruction eliminated. Thirteen kidneys were resected by surgical operation. Conclusion ^99Tc^m - DTPA renal dynamic imaging is a very efficient way to choose therapy methods for upper urinary tract calculus. It is very important to observe the renal functions at early stage in order to reserve renal functions and avoid kidney resection.