彩色多普勒超声评价经皮肾镜技术围手术期肾脏血流动力学  

Color Doppler ultrasonography in evaluation on renal hemodynamiacs in perioperation of percutaneous nephrolithotomy

作　　者：刘莉[1] 秦民惠[1] 穆靓[1] 李莘[1] 韦爱华[1] 

机构地区：[1]陕西省人民医院超声科,陕西西安710068

出　　处：《中国介入影像与治疗学》2011年第5期371-375,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：陕西省科学技术厅社发攻关项目(2009K17-05)

摘　　要：目的探讨经皮肾镜技术（PCNL）对围手术期肾脏血流动力学的影响。方法应用CDFI观察30例接受单侧、单通道PCNL患者术前1天及术后5-7天患侧各级肾动脉血流参数,并进行统计学分析。结果术后各级肾动脉阻力指数（RI）均低于术前,肾门处主肾动脉、叶间动脉、小叶间动脉舒张末期血流速度（Vmin）升高（P〈0.05）。重度积水患者术后段动脉、叶间动脉RI降低（P〈0.05）,叶间动脉Vmin增加（P〈0.05）;中度积水患者术后各级肾动脉RI降低（P〈0.05）,主肾动脉、小叶间动脉Vmin增加（P〈0.05）;轻度积水患者术后主肾动脉、段动脉RI降低（P〈0.05）,段动脉Vmin增加（P〈0.05）;无积水患者术后段动脉、叶间动脉RI降低（P〈0.05）。结论 PCNL术后短期内患侧肾脏肾动脉舒张期灌注改善,RI降低。CDFI可观察肾内血流灌注,并量化肾内血流动力学信息。Objective To evaluate the impacts of percutaneous nephrolithotomy（PCNL） on perioperative renal hemodynamics.Methods The hemodynamics of operated renal arteries of 30 patients who underwent unilateral PCNL with single pole access were observed 1 day before and 5—7 days after operation with CDFI.Parameters were analyzed statistically.Results After operation,resistance index（RI） of renal arteries decreased（P0.05）.The diastolic flow statistically increased at main renal artery（MRA） of renal hilus,interlobar renal artery and interlobular renal artery（all P0.05）.After PCNL,in serious hydronephrosis patients,RI decreased（P0.05） at segmental renal artery（SRA） and interlobar artery,end-diastolic flow velocity（Vmin） increased at interlobar renal artery（P0.05）.In moderate hydronephrosis patients,RI decreased at all renal arteries（P0.05） after PCNL,Vmin increased at MRA and interlobular renal artery（P0.05）.In minor hydronephrosis patients,RI decreased at MRA and SRA,Vmin increased at SRA.In patients without hydronephrosis,RI changeed like serious hydronephrosis patients.Conclusion After PCNL,ipsilateral renal perfusion improves,renal diastolic flow increases and RI decreases.CDFI can be used to observe the blood perfusion of kidney,and provide quantitative information of renal hemodynamics.

关 键 词：经皮肾镜术 超声检查 多普勒 彩色 血流动力学 

分 类 号：R445.1[医药卫生—影像医学与核医学]