彩色多普勒超声评价经皮肾镜超声弹道气压碎石术对肾血流灌注变化的影响

摘要

目的 运用彩色多普勒超声评价经皮肾镜超声弹道气压碎石术治疗对肾血流灌注变化的影响.资料与方法 观察60例经皮肾镜超声弹道气压碎石术治疗的患者肾动脉血流彩色多普勒超声表现,对患者术前、术后各级肾动脉血流参数进行分析.结果 术后肾叶间动脉、段动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)高于术前,差异有统计学意义(t=3.570、2.517、3.213、2.957,P＜ 0.05或P＜0.01),阻力指数(RJ)术前、术后比较差异无统计学意义(t=0.808、1.099,均P＞0.05).肾主动脉远心端、近心端PSV、EDV及肾主动脉近心端RI术前、术后比较差异无统计学意义(t=0.142、1.580、0.123、0.834、0.862,均P＞ 0.05),术后肾主动脉远心端RI低于术前,差异有统计学意义(t=2.197,P＜0.05).结论 经皮肾镜超声弹道气压碎石术能有效改善肾内血管的血流灌注.%Purpose To evaluate the effect of percutaneous nephrolithotripsy with pneumatic and ultrasonic lithotripsy on renal perfusion by using color Doppler ultrasound. Materials and Methods A total of 60 patients with renal calculi who underwent percutaneous nephrolithotripsy with pneumatic and ultrasonic lithotripsy were enrolled in this study. The clinical data were analyzed retrospectively before and after surgery. Results The peak systolic velocity (PSV) and end-diastolic velocity (EDV) of renal interlobar artery and renal segmental artery showed significant difference between the patients with and without surgery. PSV and EDV increased remarkably after surgery (f=3.570, 2.517, 3.213, 2.957; P < 0.05 or P < 0.01). The resistance index (RI) of renal interlobar artery and renal segmental artery were not significant difference between the patients with and without surgery (/=0.808, 1.099; both P > 0.05). The PSV and EDV of distal ends of main renal artery and proximal main renal artery, and RI of proximal main renal artery were not significant difference between the patients with and without surgery (t=0A42, 1.580, 0.123, 0.834, 0.862; all P > 0.05). The RI of distal main renal artery were significant difference between the patients with and without surgery, RI dropped distinctly after surgery (/=2.197, P < 0.05). Conclusion Percutaneous nephrolithotripsy with pneumatic and ultrasonic lithotripsy can improve the blood perfusion especially for interlobar arteries of the kidney.