彩色多普勒超声对输尿管软镜碎石术积水肾脏血流动力学的评价  

Hemodynamic evaluation of hydronephrosis with flexible ureteroscopic lithotripsy by color doppler flow imaging ultrasonography

作　　者：穆靓[1] 孙园 韦爱华[1] 徐姣姣[1] 刘莉[1] 南淑良 管湘平[1] 梁亮[3] MU Liang;SUN Yuan;WEI Aihua;XU Jiaojiao;LIU Li;NAN Shuliang;GUAN Xiangping;LIANG Liang(Ultrasound Diagnosis Center,Shaanxi People′s Hospital,Xi′an,Shaanxi 710068,China;Department of Hemodialysis,East Area of the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an,Shaanxi 710089,China;Department of Urology,Shaanxi People's Hospital,Xi′an,Shaanxi 710068,China)

机构地区：[1]陕西省人民医院超声诊断中心,西安710068 [2]西安交通大学第一附属医院东院血液透析室,西安710089 [3]陕西省人民医院泌尿病院,西安710068

出　　处：《重庆医学》2019年第18期3096-3098,共3页Chongqing medicine

基　　金：国家自然科学基金青年项目(81502205);陕西省重点研发计划一般项目(2017SF-267,S2108-SF-YBSF-0667)

摘　　要：目的探讨彩色多普勒超声(CDFI)评价输尿管软镜碎石术围术期不同程度积水肾脏的血流动力学情况。方法选择2016年11月至2018年10月陕西省人民医院进行输尿管软镜碎石术的单发肾结石患者51例,根据术前积水程度分为中重度积水组(n=11)及轻度-无积水组(n=40),动态观察两组患者术前1d及术后7d叶间动脉阻力指数(RI),并进行统计学分析。结果术前1d检查,中重度积水组患者肾脏的叶间动脉RI为(0.72±0.03),明显高于轻度-无积水组患者(0.63±0.04),两组比较差异有统计学意义(t=0.085,P=0.000)。术后7d复查,中重度积水组患者术后RI为(0.67±0.02),较术前明显降低,差异有统计学意义(t=-0.049,P=0.000);但仍高于轻度-无积水组患者的RI(0.64±0.03),且差异有统计学意义(t=0.028,P=0.001);而轻度-无积水组手术前后比较,差异无统计学意义(t=0.008,P=0.790)。结论CDFI可以用RI值的方式量化输尿管软镜碎石手术围术期肾内动脉灌注。Objective To evaluated the renal hemodynamics in different hydronephrosis during perioperative period with flexible ureteroscopic lithotripsy by color doppler flow imaging (CDFI) ultrasonography. Methods The hemodynamic of 51 patients with single renal calculi who underwent unilateral flexible ureteroscope lithotripsy from Nov.2016 to Oct.2018 in Shaanxi People′s hospital were collected and divided into the moderate-severe hydrocephalus group (n =11) and mild-non hydrocephalus group (n =40).The resistance index (RI) of interlobar arteries was recorded 1 day before operation and 7 days after operation,and analyzed statistically. Results The RI of renal interlobar artery in the moderate-severe hydrocephalus group (0.72± 0.03 ) was higher compared with the mild-non hydrocephalus group (0.63±0.04) at 1 day before operation,the difference between the two groups was statistically significant (t =0.085, P=0.000).In the follow-up measurement at 7 days after operation,the RI (0.67±0.02) decreased in the moderate-severe hydrocephalus group compared with preoperative (t =-0.049, P=0.000),but was still higher than that in the mild-non hydrocephalus group (0.64±0.03),the difference between the two groups was statistically significant (t = 0.028 , P=0.001).There was no significant difference between preoperative and postoperative measurements in the mild-non hydrocephalus group (t =0.008, P=0.790). Conclusion CDFI can be used to quantificat the renal hemodynamics by RI value during the perioperative period of flexible ureteroscope lithotripsy.

关 键 词：超声检查 多普勒 彩色 输尿管软镜碎石术 围术期 肾 血流动力学 

分 类 号：R445.1[医药卫生—影像医学与核医学]