CN113069146A - 一种患儿单侧肾积水的评估方法 - Google Patents
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Abstract
本发明公开了一种患儿单侧肾积水的评估方法：应用二维超声详细测量并计算出患儿双肾的体积，根据K＝VL/VR，计算K值，通过计算的K值与前期研究得到的K值阈值对比可直观反映患者的病情变化，我们前期开展的工作表明，该指标不仅可用于UPJO术后的肾积水恢复情况、手术效果的评价，同样可以运用于先天性肾积水术前的预后判断，为临床医生提供评估病情变化、手术时机提供科学的、有说服力的量化依据，对患儿临床病情的监测和远期随访管理有积极意义。
Description
技术领域
本发明涉及肾积水评估技术领域，具体为一种患儿单侧肾积水的评估方法。
背景技术
小儿肾积水在小儿外科中是一种常见疾病，随着患儿产前发现肾积水的几率逐渐升高，是否进行手术治疗、预后、手术时机的把握以及术后肾积水改善情况的评估现逐步受到临床医生、患者及其家属的重视。
一般来说，轻、中度的肾积水可以采取保守治疗的方式，其原因主要是轻、中度的肾积水可以通过内科保守治疗，且很大程度上可以得到缓解，仅当肾积水程度加重、肾小球滤过率逐步降低时才会进行手术治疗。寻求监测肾功能发生变化对手术时机的把握就显得相当关键。故小儿肾积水的诊治中最为关键的一项就是监测肾小球滤过率的变化，它预示着手术时间的选择，也对患儿的预后有着重要的影响，所以一个可以监测早期肾功能恶化的敏感方法显得极为重要。
静脉肾盂造影、增强CT以及灌注成像、核素肾扫描作为主要的影像学检查，虽可以进一步了解肾积水的程度、梗阻以及肾功能情况，但需要相关的软件来进行相关计算和重建，不仅浪费时间、精力和资源，且价格昂贵，还有一定辐射，对发育中的患儿极其不利。
目前尚没有单独的一种影像学检查可以明确辨别诊断并提供相应的治疗方案建议，缺乏一种评估小儿肾积水严重程度、手术时机的选择及术后肾积水恢复情况评价的方法，既要简便易行、价格低廉，又适合于各级医院的推广应用。
发明内容
本发明解决的技术问题在于克服现有技术的缺陷，提供一种患儿单侧肾积水的评估方法。
为实现上述目的，本发明提供如下技术方案：一种患儿单侧肾积水的评估方法，包括以下步骤：
S1：检查前准备：膀胱内尿液排空10分钟后；
S2：超声检查患儿双肾，详细测量并记录各项数值，并计算双肾体积，以上各项数值均分别测量3次，取其平均值后再计算；
S3：约定左肾体积与右肾体积的比值为常数K，即K＝VL/VR，计算K值；
S4：计算得到的K值与前期研究得到的K值阈值相对比，判断其肾积水程度；
优选的，首次提出患者儿自身同期双侧肾脏体积互为参照的理念，现有科研报道重点仍关注单侧肾脏体积及各径线与各相关疾病的关系，研究均未提及双肾比值在临床中的运用及意义。
优选的，基于前期科研项目的研究，在传统的肾脏体积估算公式的基础上
提出了患儿自身双肾体积比值(K)的定义及涵义，提供了一个新的用于评估小儿肾积水严重程度、手术时机、预后和术后积水改善情况的量化指标，为肾积水患儿随访提供一个科学的、无创的、低辐射和简便、低廉的方案。
与现有技术相比，本发明的有益效果是：
本发明可直观反映患者的病情变化，我们前期开展的工作表明，该指标不仅用于UPJO术后的肾积水恢复情况、手术效果的评价满意，同样可以运用于先天性肾积水术前的预后判断，为临床医生提供评估病情变化、手术时机提供科学的、有说服力的量化依据，对患儿临床病情的监测和远期随访管理有积极意义。
双肾体积比值科学、经济、无创，避免患儿接受过多的影像学检查，避免不必要的肾造瘘及重复插拔双J管，避免不必要的二次手术。
该计算方式简单易行，患儿只在基层医院即可完成，还能在一定程度上对小儿肾积水患者起到分级分流诊疗的作用。
附图说明
图1为本发明的操作流程图。
具体实施方式
下面将结合本发明实施例中的附图，对本发明实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例仅仅是本发明一部分实施例，而不是全部的实施例。基于本发明中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本发明保护的范围。
请参阅图1，本发明提供一种技术方案：一种患儿单侧肾积水的评估方法，所述一种患儿单侧肾积水的评估方法包括以下步骤：
S1：检查前准备：膀胱内尿液排空10分钟后；
S2：超声检查患儿双肾，详细测量并记录各项数值：双肾各径线；
S3：上下径(L)：患儿取仰卧位，在腋后线做纵切扫查，显示肾脏的纵切面上下极的顶点间的距离；
S4：纵切面左右径(D1)：体位及扫查同S1，紧靠肾门的肾实质最内侧缘至外侧缘的距离；
S5：横切面左右径(D2)：体位同S1，在腋后线做横切扫查，显示肾脏的横切面及肾门，紧靠肾门的肾实质最内侧缘至外侧缘的距离；
S6：前后径(W)：体位及扫查同S3，垂直于左右径的最大距离。
以上各项数值均分别测量3次，取平均值；
S7：约定左肾体积与右肾体积的比值为常数K，即K＝VL/VR，计算K值；
S8：计算得到的K值与前期研究得到的K值阈值相对比，判断其肾积水程度。
尽管已经示出和描述了本发明的实施例，对于本领域的普通技术人员而言，可以理解在不脱离本发明的原理和精神的情况下可以对这些实施例进行多种变化、修改、替换和变型，本发明的范围由所附权利要求及其等同物限定。
Claims (3)
1.一种患儿单侧肾积水的评估方法，其特征在于，包括以下步骤：
S1：检查前准备：膀胱内尿液排空10分钟后；
S2：超声检查患儿双肾，详细测量并记录各项数值，并计算双肾体积，以上各项数值均分别测量3次，取其平均值后再计算；
S3：约定左肾体积与右肾体积的比值为常数K，即K＝VL/VR，计算K值；
S4：计算得到的K值与前期研究得到的K值阈值相对比，判断其肾积水程度；
2.根据权利要求1所述的一种患儿单侧肾积水的评估方法，其特征在于：首次提出患者儿自身同期双侧肾脏体积互为参照的理念，现有科研报道重点仍关注单侧肾脏体积及各径线与各相关疾病的关系，研究均未提及双肾比值在临床中的运用及意义。
3.根据权利要求1所述的一种患儿单侧肾积水的评估方法，其特征在于：基于前期科研项目的研究，在传统的肾脏体积估算公式的基础上
提出了患儿自身双肾体积比值(K)的定义及涵义，提供了一种新的用于评估小儿肾积水严重程度、手术时机、预后和术后积水改善情况的量化指标，为肾积水患儿随访提供一个科学的、无创的、低辐射和简便、低廉的方案。
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Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20050058598A1 (en) * | 2002-05-15 | 2005-03-17 | Hadassa Degani | Method and apparatus for quantitatively evaluating a kidney |
| CN104537267A (zh) * | 2015-01-16 | 2015-04-22 | 广东省人民医院 | 一种肾小球滤过率评估系统 |
| CN106667513A (zh) * | 2016-12-15 | 2017-05-17 | 袁小东 | 检测肾脏滤过功能的ct测量方法 |
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20050058598A1 (en) * | 2002-05-15 | 2005-03-17 | Hadassa Degani | Method and apparatus for quantitatively evaluating a kidney |
| CN104537267A (zh) * | 2015-01-16 | 2015-04-22 | 广东省人民医院 | 一种肾小球滤过率评估系统 |
| CN106667513A (zh) * | 2016-12-15 | 2017-05-17 | 袁小东 | 检测肾脏滤过功能的ct测量方法 |
Non-Patent Citations (2)
| Title |
|---|
| 余灵安等: "单侧输尿管结石致肾绞痛急性发作患者肾实质CT值特征分析", 《中国全科医学》 * |
| 刘全启等: "CT扫描测量肾实质体积评价成人先天性梗阻侧肾脏肾小球滤过率的价值", 《现代实用医学》 * |
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