标准单通道、双通道PCNL对肾结石患者肾血流动力学的影响  

Clinical Effect of PCNL on Renal Hemodynamics in a Standard Single Channel and a Double Channel

作　　者：苏学锋[1] 黄庭芳[1] 陈宝琨[1] 

机构地区：[1]福建医科大学附属二院泌尿外科,福建泉州362000

出　　处：《医学临床研究》2015年第12期2317-2320,共4页Journal of Clinical Research

摘　　要：【目的】比较标准单通道经皮肾镜取石术（PCNL）和标准双通道PCNL对肾脏血流动力学的影响。【方法】选择2012年6月至2015年6月本院收治的159例肾结石患者，将其随机分成标准双通道组（n=77）和标准单通道组（n=82）。标准单通道组采用单通道PCNL术，双通道组采用双通道PCNL术，观察两组患者术前、术后30d肾脏血流动力学的变化。【结果】标准双通道组的手术时间显著高于标准单通道组（P〈0．05），标准双通道组的术中出血量及术中补液量显著低于标准单通道组（P〈0．05）；术后30d两组患者肾主动脉、段间动脉、叶间动脉的收缩期峰值流速（Vmax）、S／D显著高于术前，血流阻力指数（RI）显著低于术前（P〈0．05），标准双通道组肾主动脉、段间动脉、叶间动脉的Vmax、S／D显著高于单通道组，RI显著低于单通道组（P〈0．05）；两组患者术后肾小球滤过率（GFR）均显著低于术前（P〈0．05），两组术后GFR无显著性差异（P〉0．05）。[结论]PCNL术对患者肾血流动力学会产生一定的影响，双通道PCNL术中出血及术中补液均较少，清石效果好，值得临床推广。[Objective]To compare the effects of the standard single channel percutaneous nephro-lithotomy （PCNL）and double channel percutaneous nephro-lithotomy （PCNL） on renal hemodynamics. [Methods]A total of 159 patients with kidney stones selected from June 2012 to June 2015 in our hospital was divided into a double channel group （N=77） and a single channel group （N=82）. The patients of the double channel group were treated with the double channel PCNL and the patients of single channel group were treated with the single channel PCNL to observe the effects on renal hemodynamics of patients in the two groups before PCNL and after PCNL 30 days. [Results]The operation time of the double channel group was significantly higher than that of the single channel group （P 〈 0.05） ; the bleeding amount and intraoperative rehydration amount of the double channel group were significantly lower than in the single channel group （ P 〈0.05）; After 30 days, Vmax and S / D of the renal artery, segmental artery,and interlobar artery was significantly higher than that of preopertative, and RI was significantly lower than that of preopertative （P 〈0.05）. In the double channel group, Vmax and S / D of renal artery, segmental artery,interlobar artery was significantly higher than that of the single channel group; RI was significantly lower than that of the single channel group （P 〈0.05）. After the operation, GFR values were all significantly lower than before operation in both groups （ P〈0.05） ; the change of GFR values between preoperative and postoperative in the single channel group of patients was significantly greater than that of the double channel group （ P〈0.05）. [Conclusion]PCNL surgery has effects on renal hemodynamic to a degree. Because of less damage is caused on the blood vessels in the double channel PCNL process, the effects on the renal hemodynamic is smaller than that of the single channel PCNL.

关 键 词：肾结石/外科学 肾/外科学 血流动力学 

分 类 号：R692.4[医药卫生—泌尿科学]