输尿管软镜碎石术对肾脏血流动力学影响的前瞻性评估  

Prospective evaluation of the effect of flexible ureteroscopic lithotripsy on renal hemodynamics

作　　者：庞翔 何猛 林俊 张瑞明 李唤春 PANG Xiang;HE Meng;LIN Jun;ZHANG Ruiming;LI Huanchun(Urinary Surgery,the 923rd Hospital of PLA Joint Logistic Support Force,Nanning 530023,China;Ultrasound Diagnosis Department,the 923rd Hospital of PLA Joint Logistic Support Force,Nanning 530023,China)

机构地区：[1]中国人民解放军联勤保障部队第九二三医院泌尿外科,广西南宁530023 [2]中国人民解放军联勤保障部队第九二三医院超声诊断科,广西南宁530023

出　　处：《临床医学研究与实践》2025年第6期41-44,共4页Clinical Research and Practice

基　　金：广西壮族自治区卫生健康委自筹经费科研课题(No.Z-A20231040)。

摘　　要：目的探讨输尿管软镜碎石术(FURL)对肾脏血流动力学的影响。方法前瞻性纳入2023年10月至2024年6月在我院接受FURL的78例患者,根据输尿管软镜导入鞘(UAS)直径将患者分为10/12 Fr组(12例,占15.38%)、12/14 Fr组(49例,占62.82%)和14/16 Fr组(17例,占21.79%)。比较三组患者术前、术后的弓状动脉和肾动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)、搏动指数(PI)、阻力指数(RI)。结果术前、术后,三组的肾动脉PSV、EDV、PI、RI比较,差异无统计学意义(P>0.05);术后,10/12Fr组的弓状动脉RI高于术前(P<0.05);术后,14/16 Fr组的弓状动脉PSV低于术前(P<0.05)。结论小直径的UAS可能引起肾脏RI升高,当输尿管软镜与UAS间隙大于2.5 Fr时,对于单侧无积水的肾结石,FURL是安全有效的。Objective To investigate the effect of flexible ureteroscopic lithotripsy(FURL)on renal hemodynamics.Methods A total of 78 patients who underwent FURL in our hospital from October 2023 to June 2024 were prospectively enrolled.According to the diameter of ureteral access sheath(UAS),the patients were divided into 10/12 Fr group(12 cases,15.38%),12/14 Fr group(49 cases,62.82%)and 14/16 Fr group(17 cases,21.79%).The peak systolic velocity(PSV),end diastolic velocity(EDV),pulsatility index(PI)and resistance index(RI)of arcuate artery and renal artery before and after operation were compared among the three groups.Results There were no significant differences in PSV,EDV,PI and RI of renal artery among the three groups before and after operation(P>0.05);after operation,the RI of arcuate artery in the 10/12 Fr group was higher than that before operation(P<0.05);after operation,the PSV of arcuate artery in the 14/16 Fr group was lower than that before operation(P<0.05).Conclusion Small-diameter UAS may cause an increase in renal RI,when the gap between flexible ureteroscope and UAS is greater than 2.5 Fr,FURL is safe and effective for unilateral renal calculi without hydronephrosis.

关 键 词：输尿管软镜碎石术 输尿管软镜导入鞘 直径 血流动力学 

分 类 号：R699[医药卫生—泌尿科学]