CAJ | 학술논문

目的探讨经皮肾镜技术(PCNL)对围手术期肾脏血流动力学的影响.方法应用CDFI观察30例接受单侧、单通道PCNL患者术前1天及术后5～7天患侧各级肾动脉血流参数,并进行统计学分析.结果术后各级肾动脉阻力指数(RI)均低于术前,肾门处主肾动脉、叶间动脉、小叶间动脉舒张末期血流速度(Vmin)升高(P＜0.05).重度积水患者术后段动脉、叶间动脉RI降低(P＜0.05),叶间动脉Vmin增加(P＜0.05)；中度积水患者术后各级肾动脉RI降低(P＜0.05),主肾动脉、小叶间动脉Vmin增加(P＜0.05)；轻度积水患者术后主肾动脉、段动脉RI降低(P＜0.05),段动脉Vmin增加(P＜0.05)；无积水患者术后段动脉、叶间动脉RI降低(P＜0.05).结论PCNL术后短期内患侧肾脏肾动脉舒张期灌注改善,RI降低.CDFI可观察肾内血流灌注,并量化肾内血流动力学信息.
목적 탐토경피신경기술(PCNL)대위수술기신장혈류동역학적영향.방법응용CDFI관찰30례접수단측、단통도PCNL환자술전1천급술후5～7천환측각급신동맥혈류삼수,병진행통계학분석.결과술후각급신동맥조력지수(RI)균저우술전,신문처주신동맥、협간동맥、소협간동맥서장말기혈류속도(Vmin)승고(P＜0.05).중도적수환자술후단동맥、협간동맥RI강저(P＜0.05),협간동맥Vmin증가(P＜0.05)；중도적수환자술후각급신동맥RI강저(P＜0.05),주신동맥、소협간동맥Vmin증가(P＜0.05)；경도적수환자술후주신동맥、단동맥RI강저(P＜0.05),단동맥Vmin증가(P＜0.05)；무적수환자술후단동맥、협간동맥RI강저(P＜0.05).결론PCNL술후단기내환측신장신동맥서장기관주개선,RI강저.CDFI가관찰신내혈류관주,병양화신내혈류동역학신식.
Objective To evaluate the impacts of pereutaneous nephrolithotomy (PCNL) on perioperative renal hemodynamics.Methods The hemodynamics of operated renal arteries of 30 patients who underwent unilateral PCNL with single pole access were observed 1 day before and 5-7 days after operation with CDFI.Parameters were analyzed statistically.Results After operation,resistance index (RI) of renal arteries decreased (P＜0.05).The diastolic flow statistically increased at main renal artery (MRA) of renal hilus,interlobar renal artery and interlobular renal artery (all P＜0.05).After PCNL,in serious hydronephrosis patients,RI decreased (P＜0.05) at segmental renal artery (SRA) and interlobar artery,end-diastolic flow velocity (Vmin) increased at interlobar renal artery (P＜0.05).In moderate hydronephrosis patients,RI decreased at all renal arteries (P＜0.05) after PCNL,Vmin increased at MRA and interlobular renal artery (P＜0.05).In minor hydronephrosis patients,RI decreased at MRA and SRA,Vmin increased at SRA.In patients without hydronephrosis,RI changeed like serious hydronephrosis patients.Conclusion After PCNL,ipsilateral renal perfusion improves,renal diastolic flow increases and RI decreases.CDFI can be used to observe the blood perfusion of kidney,and provide quantitative information of renal hemodynamics.