文章摘要

彩色多普勒超声检查评价输尿管软镜取石术对围手术期肾脏血流动力学的影响

作者: 1穆 靓, 2孙 园, 1刘 莉, 1韦 爱华, 1南 淑良, 1管 湘平, 3梁 亮
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外科,西安 710068
通讯: 南 淑良 Email: 641800225@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.01.010
基金: 国家自然科学基金(81502205);陕西省重点研发计划(2017SF-267)。

摘要

目的:探讨输尿管软镜碎石手术对肾脏血流动力学的影响。方法:分析2017年1月至2018年12月56例输尿管软镜碎石术的单发肾结石患者,应用超声彩色多普勒血流显像(color Doppler flow imaging,CDFI)观察术侧肾脏动脉血流参数,记录术后1 h内及术后5 d肾内动脉血流参数,与术前1 d结果比较。结果:与术前血流参数相比,术后1 h内术侧肾脏段动脉舒张末期流速(Vmin)减低、阻力指数(resistance index,RI)增高(P<0.017),收缩期峰值流速(Vmax)无明显变化(P>0.017);术后5 d复查,Vmin回升、RI降低(P<0.017),Vmax,Vmin及RI与术前测值相比无明显统计学差异(P>0.017)。结论:CDFI可以量化观察输尿管软镜取石术围手术期肾内血流灌注,单发肾结石输尿管软镜手术后会出现短期、可逆性的肾动脉Vmin减低、RI增高。
关键词: 彩色多普勒超声;输尿管软镜取石术;肾脏血流动力学

Effects of flexible ureteroscope lithotripsy on renal hemodynamics evaluated by color doppler ultrasonography

Authors: 1MU Liang, 2SUN Yuan, 1LIU Li, 1WEI Aihua, 1NAN Shuliang, 1GUAN Xiangping, 3LIANG Liang
1 Ultrasound Diagnosis Center, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
2 Department of Hemodialysis, East Area of First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710089, China
3 Department of Urology, Shaanxi Provincial People’s Hospital, Xi’an 710068, China

CorrespondingAuthor:NAN Shuliang Email: 641800225@qq.com

Foundation: This work was supported by the National Natural Science Foundation (81502205) and Key Research and Development Program of Shaanxi Province (2017SF-267), China.

Abstract

Objective: To evaluate the effects of flexible ureteroscope lithotripsy on perioperative renal hemodynamics. Methods: The hemodynamic of operated renal arteries of 56 patients with renal calculi who underwent unilateral flexible ureteroscope lithotripsy from Jan. 2017 to Dec. 2018 were examined at preoperation and 1 h and 5 days postoperation by color Doppler flow imaging (CDFI). Parameters were analyzed statistically. Results: In 1 hour after the operation, a statistically significant in decrease of diastolic flow (Vmin) and increase of resistance index (RI) at segmental renal arteries were found compared with preoperative (P<0.017). In the follow-up measurement of 5 days after the operation, the differences disappeared (P>0.017). Conclusion: CDFI can be used to observe the blood perfusion in kidney after flexible ureteroscope lithotripsy, and quantitate the information of renal hemodynamics simply and rapidly. Renal Vmin decreased and RI increased can be found at postoperative in short-term, and the changes are reversible.
Keywords: color doppler ultrasonography; flexible ureteroscope lithotripsy; renal hemodynamic