现代泌尿外科杂志
現代泌尿外科雜誌
현대비뇨외과잡지
JOURNAL OF MODERN UROLOGY
2014年
11期
712-715
,共4页
李许睿%李文刚%陈伯成%周大庆%禹岳华%王坚%刘尚文%何猛%庞翔%江波%余小祥
李許睿%李文剛%陳伯成%週大慶%禹嶽華%王堅%劉尚文%何猛%龐翔%江波%餘小祥
리허예%리문강%진백성%주대경%우악화%왕견%류상문%하맹%방상%강파%여소상
肾血管阻力指数%经皮肾镜取石术%上尿路结石%肾积水
腎血管阻力指數%經皮腎鏡取石術%上尿路結石%腎積水
신혈관조력지수%경피신경취석술%상뇨로결석%신적수
intrarenal resistance index%standard percutaneous nephrolithotripsy%upper urinary stone,hydronephrosis%colour Doppler ultrasound
目的：探讨标准经皮肾镜取石术对上尿路结石合并肾积水患者肾血管阻力指数的影响。方法60例单侧上尿路结石并对侧肾功能正常患者按患肾积水程度分为轻度（15例）、中度（32例）、重度（13例）。采用标准通道超声联合气压弹道经皮肾镜碎石，其中单通道52例、双通道8例。应用彩色多普勒血流显像测定术前24 h和术后0、48、120 h双肾肾血管阻力指数。比较手术前后各组肾血管阻力指数的差异。结果经皮肾镜取石术术后各组患侧肾脏肾血管阻力指数即刻升高，并维持至术后48 h ，与术前比较有显著性统计学差异（P＜0．01），术后5 d恢复至术前水平（P＞0．05）；各组健侧肾脏术后肾血管阻力指数变化特点与患肾相同。结论标准经皮肾镜取石术可造成早期双肾血流降低，而双肾血流改变与术前肾积水程度无关。
目的：探討標準經皮腎鏡取石術對上尿路結石閤併腎積水患者腎血管阻力指數的影響。方法60例單側上尿路結石併對側腎功能正常患者按患腎積水程度分為輕度（15例）、中度（32例）、重度（13例）。採用標準通道超聲聯閤氣壓彈道經皮腎鏡碎石，其中單通道52例、雙通道8例。應用綵色多普勒血流顯像測定術前24 h和術後0、48、120 h雙腎腎血管阻力指數。比較手術前後各組腎血管阻力指數的差異。結果經皮腎鏡取石術術後各組患側腎髒腎血管阻力指數即刻升高，併維持至術後48 h ，與術前比較有顯著性統計學差異（P＜0．01），術後5 d恢複至術前水平（P＞0．05）；各組健側腎髒術後腎血管阻力指數變化特點與患腎相同。結論標準經皮腎鏡取石術可造成早期雙腎血流降低，而雙腎血流改變與術前腎積水程度無關。
목적：탐토표준경피신경취석술대상뇨로결석합병신적수환자신혈관조력지수적영향。방법60례단측상뇨로결석병대측신공능정상환자안환신적수정도분위경도（15례）、중도（32례）、중도（13례）。채용표준통도초성연합기압탄도경피신경쇄석，기중단통도52례、쌍통도8례。응용채색다보륵혈류현상측정술전24 h화술후0、48、120 h쌍신신혈관조력지수。비교수술전후각조신혈관조력지수적차이。결과경피신경취석술술후각조환측신장신혈관조력지수즉각승고，병유지지술후48 h ，여술전비교유현저성통계학차이（P＜0．01），술후5 d회복지술전수평（P＞0．05）；각조건측신장술후신혈관조력지수변화특점여환신상동。결론표준경피신경취석술가조성조기쌍신혈류강저，이쌍신혈류개변여술전신적수정도무관。
ABSTRACT:Objective To evaluate the effect of standard percutaneous nephrolithotripsy (PCNL) on the renal resistance index (RI) of patients with upper urinary stone and hydronephrosis .Methods A total of 60 patients with unilateral upper u‐rinary stones and normal contralateral kidneys were divided into 3 groups according to the severity of hydronephrosis :mild (group 1 ,15 cases) ,moderate (group 2 ,32 cases) ,high grade (group 3 ,13 cases) .All patients received standard PCNL with EMS Ⅲ :52 patients with single tract and 8 patients with two tracts .Intrarenal RI of obstructed and normal contralateral kid‐neys were measured 24 h before operation and 0 h ,48 h ,and 120 h after operation .All data were analyzed by multilevel model with a mixture of response types using SPSS11 .0 .Results After PCNL ,the values of intrarenal RI of obstructed kidneys rose immediately and remained high until 48h after PCNL (P<0 .01 compared to preoperation) .They returned to the level of pre‐PCNL at 120h after PCNL (P>0 .05 compared to preoperation) .After PCNL ,the changes of intrarenal RI of normal contra‐lateral kidneys were similar to those of obstructed kidneys .Conclusions PCNL may lead to early decrease of blood flow in both kidneys ,which doesn't relate to the severity of hydronephrosis .
