飞行学员医学选拔中肾下垂的检查方法比较及影响因素探究
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摘要
目的对比触诊和B超在肾下垂程度判定中的一致性及其影响因素,为我军飞行学员医学选拔中肾下垂检查手段的改进提供参考依据。方法序贯入选我军某地飞行学员医学选拔中肋下触及肾脏的106例学员,依据触诊肾下垂程度不同分为5个亚组,同时行卧立位B超检查测量肾脏活动度,分析触诊和B超检查在判定肾下垂程度时的相关性。结果对触诊肾下垂各亚组的肾脏活动度进行比较,差异有统计学意义(P<0.01),且随着肋下触及肾脏大小的增加,B超所示肾脏活动度呈增大的趋势。肋下触及肾脏大小和肾脏活动度呈现正相关(r=0.448,P<0.01)。肾脏活动度与收缩压、舒张压、心率、体质量指数、握力、胸围等测量指标无明显相关性。结论对肋下触及肾脏到达一定程度或腹肌坚硬、肾脏触摸不清的学员,应当结合卧立位B超检查进一步明确肾下垂程度,并结合病史,综合判定体检结果,以实现精准招飞。
Objective To compare the results of renal palpation and ultrasound in detecting nephroptosis in order to provide reference for improving medical approaches to the selection of flying cadets. Methods One hundred and six military pilot applicants whose kidneys were palpable below the costal arch were recruited sequentially and further divided into five subsets according to the degree of nephroptosis. The extent to which a kidney descended during a position change from the supine to upright was recorded by ultrasound. The association between the degrees of nephroptosis detected by palpation and by ultrasound was analyzed. Results One-way ANOVA revealed that the extent to which kidneys descended during the position change detected by ultrasound in the five subsets was significantly different(P<0.01), and there was a moderately positive correlation between the results of palpation and those of ultrasound(r=0.448, P<0.01). However, the degree of nephroptosis detected by ultrasound had no correlations with blood pressure, heart rate, body mass index, grip strength or chest circumference.Conclusion The result of renal palpation upright is moderately consistent with that of ultrasound in detecting nephroptosis.
Objective To compare the results of renal palpation and ultrasound in detecting nephroptosis in order to provide reference for improving medical approaches to the selection of flying cadets. Methods One hundred and six military pilot applicants whose kidneys were palpable below the costal arch were recruited sequentially and further divided into five subsets according to the degree of nephroptosis. The extent to which a kidney descended during a position change from the supine to upright was recorded by ultrasound. The association between the degrees of nephroptosis detected by palpation and by ultrasound was analyzed. Results One-way ANOVA revealed that the extent to which kidneys descended during the position change detected by ultrasound in the five subsets was significantly different(P<0.01), and there was a moderately positive correlation between the results of palpation and those of ultrasound(r=0.448, P<0.01). However, the degree of nephroptosis detected by ultrasound had no correlations with blood pressure, heart rate, body mass index, grip strength or chest circumference.Conclusion The result of renal palpation upright is moderately consistent with that of ultrasound in detecting nephroptosis.
引文
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[5]韩其智,庞晓玲.空军飞行人员泌尿系统疾病超声检查结果分析[J].空军医学杂志,2013, 29(3):177-178.
[6]Moss SW. Floating kidneys:a century of nephroptosis and nephropexy[J]. J Urol, 1997, 158(3 Pt 1):699-702.
[7]Peeker R, Friberg P. Impaired renal arterial blood flow velocity in nephroptosis[J]. Scand J Urol Nephrol, 2000,34(3):205-207.
[8]孙立美,马红雨,董磊,等.肾脏疾病与损伤标志物[J].空军医学杂志,2015, 31(5):321-324.
[9]何继红,王荣珍.5792侧肾体检者B超肾脏病变结果与分析[J].中国超声医学杂志,1992, 8(s1):98.
[10]肖晓光,郑军,王继红,等.飞行学员肾下垂两年跟踪随访研究[J].中华航空航天医学杂志,2010, 21(3):205-208.
[11]Barber NJ, Thompson PM. Nephroptosis and nephropexy--hung up on the past?[J]. Eur Urol, 2004, 46(4):428-433.
[12]Starownik R, Golabek T, Bar K, et al. Percutaneous nephrostomy for symptomatic hypermobile kidney:a single centre experience[J]. Wideochir Inne Tech Maloinwazyjne,2014, 9(4):501-504.
[2]Murari SB, Gadepalli T, Rao VP, et al. Renal scintigraphy in diagnosis and management of nephroptosis[J]. Indian J Nucl Med, 2012, 27(1):52-54.
[3]Hoenig DM, Hemal AK, Shalhav AL, et al. Nephroptosis:a “disparaged"condition revisited[J]. Urology, 1999, 54(4):590-596.
[4]毛晓全,罗志芳,屠广治.长期立位作业工人肾脏活动度的研究[J].劳动医学,1988,(3):4-5.
[5]韩其智,庞晓玲.空军飞行人员泌尿系统疾病超声检查结果分析[J].空军医学杂志,2013, 29(3):177-178.
[6]Moss SW. Floating kidneys:a century of nephroptosis and nephropexy[J]. J Urol, 1997, 158(3 Pt 1):699-702.
[7]Peeker R, Friberg P. Impaired renal arterial blood flow velocity in nephroptosis[J]. Scand J Urol Nephrol, 2000,34(3):205-207.
[8]孙立美,马红雨,董磊,等.肾脏疾病与损伤标志物[J].空军医学杂志,2015, 31(5):321-324.
[9]何继红,王荣珍.5792侧肾体检者B超肾脏病变结果与分析[J].中国超声医学杂志,1992, 8(s1):98.
[10]肖晓光,郑军,王继红,等.飞行学员肾下垂两年跟踪随访研究[J].中华航空航天医学杂志,2010, 21(3):205-208.
[11]Barber NJ, Thompson PM. Nephroptosis and nephropexy--hung up on the past?[J]. Eur Urol, 2004, 46(4):428-433.
[12]Starownik R, Golabek T, Bar K, et al. Percutaneous nephrostomy for symptomatic hypermobile kidney:a single centre experience[J]. Wideochir Inne Tech Maloinwazyjne,2014, 9(4):501-504.