彩色多普勒超声评价肾积水穿刺造瘘术对肾血流灌注变化的影响

Using color Doppler to evaluate how fistulation affect the renal blood flow in hydronephrosis patients

目的:采用彩色多普勒超声评价肾积水穿刺造瘘术对肾血流灌注变化的影响,探讨肾功能可复性的临床价值。方法:检测53例患者67个积水肾经穿刺造瘘治疗前后的肾动脉血流的阻力指数(RI),测量积水肾治疗前后的实质厚度,与肾穿刺造瘘治疗后24h引流量比较并分组。对肾实质厚度及肾动脉血流RI进行相关分析。结果:各组之间RI及肾实质厚度比较,P均<0.01。肾实质厚度及RI与肾功能呈明显相关性(r=0.905,P<0.01;r=-0.893,P<0.01)。肾实质厚度<3mm或RI>0.81,判断肾功能不可复性的敏感度为90.5%,特异性为96.0%。结论:肾动脉血流RI>0.81或实质厚度<3mm时,可以反映积水肾的肾功能损害程度及肾血流灌注变化,并可作为临床上评价肾功能可复性的客观指标。

Objective：To evaluate how fistulation affect the renal blood flow in hydronephrotic patients by color Doppler.To explore the clinical significance of recovering renal function.Method：Fifty-three patients with 67 hydronephrosis were collected.All of them were taken the color Doppler test of resistent index（RI） of kidney artery,renal parenchyma before and after fistulation.The correlation between RI and the thickness of renal parenchyma were analyzed.Result：RI and the thickenss of the three groups had statistical significance.There was correlation between the renal function and the thickness of renal parenchyma.When the thickness of renal parenchyma was less than 3mm or RI0.81,the sensitivity to evaluate the irre-versibility was 90.5% and the specificity was 96.0%.Conclusion：When the thickness of renal parenchyma was less than 3mm or RI0.81,it can be used as an clinical marker to evaluate the reversibility for it can reflect how the renal function were injured and how the renal blood flow changed.