体外冲击波碎石术患者肾血流动力学的评估

目的探讨体外冲击波碎石术(ESWL)对肾血流指数的影响。方法选取2016年8月至2018年4月在我院行ESWL的48名肾结石患者。使用超声诊断仪进行肾内血流评估,包括同侧肾和对侧肾,计算阻力指数(RI),脉动指数(PI)和加速时间(AT)等参数。结果 ESWL治疗后同侧肾脏以及对侧肾脏的RI指数明显增高(P0.001)。ESWL后96小时RI值降低至接近治疗前。ESWL后同侧肾脏以及对侧肾脏的PI参数也显著增加(P0.001),96小时后下降至与术前相近。显示RI与PI指数的增高与患者年龄之间呈正相关(r=0.562,P0.05)。结论肾结石的体外冲击波碎石(ESWL)会导致同侧和对侧肾脏的肾灌注暂时受损,患者年龄可能是决定RI和PI参数值的主要因素。

Assessment of renal hemodynamics in patients undergoing extracorporeal shock wave lithotripsy

［Abstract］ Objective To investigate the influence of on extracorporeal shock wave lithotripsy（ESWL）on renal blood flow index. Methods Forty?eight patients from August 2016 to April 2018 were included in the study. The mean age was 50.3±14.1 years. The spectrum of blood flow of both the treated and the opposite kidney was investigated by using color Doppler ultrasonography including resistive index（RI）,pulsatility index （PI） and acceleration time （AT）. Results The ESWL treatment caused a statistically significant increases of the RI in the ipsilateral kidney as well as in the opposite kidney（P<0.001 vs pre-ESWL）. The RI decreased after 92 hours after ESWL. PI substantially increased afterESWL in both kidneys（P<0.001 vs pre?ESWL）,and decreased after 92 hours. There were statistically significant correlations shown between RI and age （r=0.562,P<0.05）. Conclusion ESWL for renal stones causes temporary impairment of the renal perfusion in both ipsilateral and contralateral kidneys. The patients age may be the main factor.