不同程度肾积水手术治疗前后对肾脏血流动力学的影响

目的 :评估彩色多谱勒血流成像 (DCFI)与静脉尿路造影 (IVU)对不同程度肾积水手术治疗前后的相关性。方法 :观察 6 4例 76个积水肾脏手术前后肾脏动脉三级分支 (肾主动脉、肾段动脉和肾叶间动脉 )收缩期峰值血流 (S)与舒张期末血流 (D)的比值 (S/D)和阻力指数 (RI)的变化 ,并与IVU结果进行比较。结果 :重度肾积水时S/D和RI值均增高 ;中度肾积水时仅S/D增高 ;轻度肾积水时血流频谱无明显改变。梗阻解除后 1月 ,中度肾积水血流频谱恢复正常 ;重度肾积水RI值也恢复正常 ,但S/D值 3月后仍未完全恢复。彩色多谱勒血流成像与静脉尿路造影结果相类似。结论 :DCFI对肾积水程度的观察和肾功能恢复的预测 ,是一种方便、无创伤性的手段 ,尤其对积水所致肾功能不全的临床评估更具有指导意义。

Influence of Hydronephrosis on Renal Circulation Flowing Kinetics before and after Operation

Objective:To estimate the relativity between DCFI and IVU to different degrees of renal hydronephrosis.Methods:The ratio of peak systolic flow velocity to least diastolic flow velocity(S/D) and the resistant index(RI) of intrarenal arterial flow (the main artery,segmental artery and interlober artery) before and after operation were observed with DCFI for 76 hydronephrosis of 64 cases.The results of DCFI were compared with those of IVU.Results:The study discovered that both S/D and RI were increased in severe hydronephrosis,and only S/D was increased in moderated hydronephrosis.The shapes of the velocity spectrum of moderated hydronephrosis recovered to the normal level after operation for one months.The RI of severe hydronephrosis also recovered to the normal level,but the S/D was not recovered after operation for three months.The changes of DCFI were as similar as those of IVU.Conclusion:The results showed that DCFI was a convenient and non-injured method to observe the degree of hydronephrosis and estimate the recovery of renal function,especially in renal function failure.