彩色多普勒超声评价体外冲击波碎石术的肾脏远期影响

Long-term changes of kidney after extracorporeal shock-wave lithotripsy evaluated by Doppler ultrasonography

目的应用多普勒超声评价肾结石体外冲击波碎石术(ESWL)后远期肾脏血液供应、体积及功能的改变。方法超声检测63例肾结石患者ESWL后3-11年双侧肾动脉血流充盈情况、肾动脉PI及RI、肾脏体积改变情况;实验室检查肾功能。结果根据是否行ESWL将双侧肾脏分为碎石组及对照组,碎石组69例,其中42例血流充盈不良,明显多于对照组;碎石组肾脏大小及皮质厚度与对照组比较差异有统计学意义;碎石组各级肾动脉PI、RI值增高,与对照组比较差异有统计学意义。碎石组6例患者行双侧ES-WL后3例出现肾功能衰竭。结论肾结石ESWL后远期可造成肾功能的损害,临床应严格掌握手术适应证。

Objective To evaluate the long-term changes of kidney after extracorporeal shock-wave lithotripsy,the renal blood supply,volume and function were determined by Doppler Ultrasonography.Methods 63 patients with renal stone were performed bilateral renal artery blood stream,PI and RI of renal artery,renal volume change detection by Doppler ultrasonography,and renal function examination by laboratory 5 month to 5 years after extracorporeal shock-wave lithotripsy.Results 42 patients with renal blood stream filling insufficient were found in all of 69 patients received the treatment,which were much than that in the control group.The renal volume and cortex depth were also significantly different from the control group.The PI and RI of all renal artery in lithotripsy group were significantly increased than that in control group.Renal failure in 3 patients and intermission high blood pressure in 2 patients were found after 6 patients received bilateral renal lithotripsy.Conclusion Renal extracorporeal shock-wave lithotripsy may damage the renal function,the indication of treatment should be strictly considered.