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目的探讨梗阻性输尿管结石时白肾征与肾周水肿的X线及CT表现,并评价其在输尿管梗阻中的临床意义。方法常规静脉肾盂造影(IVP)清晰显示白肾征患者50例,所有患者在造影后立即行CT平扫,结合临床对其X线及CT征象进行综合分析。结果 IVP显示白肾征50例中,肾周脂肪层模糊9例,消失15例;CT平扫均显示患者肾体积增大、肾实质密度均匀性增高、肾盂输尿管扩张积水及结石,其中40例还发现患肾周围有不同程度的水肿。经治疗排出结石后1周,28例复查IVP,肾盂肾盏恢复正常,白肾消失;14例复查CT平扫,肾盂肾盏及肾实质密度恢复正常,肾周水肿消失或明显减少。结论白肾征常伴有不同程度的肾周水肿,二者同时存在提示输尿管结石发生急性完全性梗阻,但患肾功能尚未明显受损,及时解除梗阻,可减少并发症,避免患肾功能受到进一步损害。
Objective To investigate the X-ray and CT findings of white kidney syndrome and perirenal edema in obstructive ureteral calculi and evaluate its clinical significance in ureteral obstruction. Methods Conventional intravenous pyelography (IVP) clearly showed 50 cases of patients with leukopenia. All patients underwent CT plain scan immediately after radiography, and combined with clinical analysis of X-ray and CT findings. Results IVP showed white kidney signs in 50 cases, the perirenal fat layer fuzzy in 9 cases, 15 cases disappeared; CT scan showed increased renal volume, renal parenchyma density uniformity, hydronephrosis and hydronephrosis, of which 40 Cases also found that there are varying degrees of edema around the kidney. One week after treatment, 28 cases were reexamined for IVP, the renal calyx returned to normal, and the white kidney disappeared. In 14 cases, the CT scan, renal pelvis and calyceal calculus and renal parenchyma returned to normal, and the peritoneal edema disappeared or decreased significantly. Conclusions White kidney syndrome is often associated with varying degrees of peritoneal edema. Concurrently, both of them suggest acute complete obstruction of ureteral calculi, but the renal function is not significantly impaired, and the obstruction is relieved in time, which can reduce the complication and prevent the renal function from being affected Further damage.