融合肾锥体在人体肾脏中的分布及在经皮肾镜通道建立中的临床意义  

The distribution of fused renal pyramid in human kidney and its clinical significance in the establishment of percutaneous nephrolithotomy channel

作　　者：黄晨 张云龙 阮远[1] 饶婷[1] 余伟民[1] 程帆[1] Huang Chen;Zhang Yunlong;Ruan Yuan;Rao Ting;Yu Weimin;Cheng Fan(Department of Urology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院泌尿外科,430060

出　　处：《中华腔镜泌尿外科杂志（电子版）》2021年第1期4-7,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：湖北省卫健委指导性科研项目(WJ2019F158)。

摘　　要：目的探讨融合肾锥体在人体肾脏内的分布情况及临床意义。方法观察2018年1月至2019年12月我中心260例患者输尿管软镜手术视野下与52例无功能肾切除标本中融合肾锥体发生情况,分析上中下组肾盏中融合肾锥体的分布规律和融合程度。结果两种方法观察到的结果具有一致性。软镜视野下和无功能肾中,上中下组肾盏中融合肾锥体出现的比例分别为72.7%、22.7%、69.2%和71.2%、21.2%、67.3%,分布差异均有统计学意义。软镜视野下上中下组肾盏中2个肾锥体融合与≥3个肾锥体融合的比例分别为38.1%与61.9%、89.8%与10.2%、51.7%与48.3%(P<0.001);无功能肾中为35.1%与64.9%,90.9%与9.1%,45.7%与54.3%(P=0.005)。结论融合肾锥体在人体肾脏中广泛存在,中组肾盏分布比例和融合程度都明显较低,选择中组肾盏建立经皮肾通道有利于降低因损伤融合肾锥体内异位血管而导致出血的风险。Objective To investigate the distribution and clinical significance of fused renal pyramid in human kidney.Methods The occurrence of conical fusion in 260 cases of flexible ureteroscope and 52 cases of non-functional nephrectomy specimens from January 2018 to December 2019 in our department was observed,and the distribution and degree of fusion in the upper,middle and lower calyx were analyzed.Results The results observed by the two methods were consistent.Under flexible ureteroscope and in non-functional kidney,the fused renal pyramid in the upper,middle and lower calyxes was 72.7%,22.7%,69.2%and 71.2%,21.2%,67.3%,respectively,and the distribution differences were statistically significant.In the upper,middle and lower calyxes,the proportion of conical fusion with 2 renal pyramid and 3 or more was 38.1%and 61.9%,89.8%and 10.2%,51.7%and 48.3%,respectively(P<0.001),and that was 35.1%and 64.9%,90.9%and 9.1%,45.7%and 54.3%in the nonfunctional kidneys(P=0.005).Conclusions The fused renal pyramid is widespread in human kidney,and the proportion of calyx distribution and degree of fusion are significantly lower in the middle group.Therefore,the establishment of percutaneous renal channels in the middle group is conducive to reducing the risk of bleeding caused by the injury of ectopic vessels in the fused renal cone.

关 键 词：融合肾锥体 肾盏 无功能肾 输尿管软镜 经皮肾通道 

分 类 号：R699[医药卫生—泌尿科学]