微创经皮肾镜取石术对肾血流动力学的影响

Effect of Minimally Invasive Percutaneous Nephrolithotomy on Renal Hemodynamics

目的探讨微创经皮肾镜取石术(MPCNL)对肾血流动力学的影响。方法采用彩色多普勒血流显像(CDFI)观察并分析52例肾结石患者单通道MPCNL术前及术后1、3个月肾主动脉、段间动脉、叶间动脉收缩期峰值流速(S)与舒张期末流速(D)的比值(S/D)和阻力指数(RI)。结果术前肾主动脉、段间动脉、叶间动脉RI值分别为0.60±0.13、0.62±0.12、0.62±0.16;术后1个月肾主动脉、段间动脉、叶间动脉RI值分别为0.61±0.14、0.61±0.15、0.61±0.18;术后3个月肾主动脉、段间动脉、叶间动脉RI值分别为0.61±0.17、0.61±0.09、0.62±0.13。术前与术后1、3个月肾主动脉、段间动脉、叶间动脉S/D、RI值比较,差异均无统计学意义(P均>0.05)。结论微创经皮肾镜取石术对肾血流动力学无影响,是治疗肾结石的一种安全的方法。

Objective To explore the effect of minimally invasive percutaneous nephrolithotomy（MPCNL） on renal hemodynamics.Methods The color doppler ultrasonograph was used to observe the ratio of diastolic peak flow velocity to end diastolic flow velocity（S/D） and the resistance index（RI） of chief renal arteries,intersegmental arteries and interlobar arteries in 52 patients with kidney stones before MPCNL,and 1 and 3 months after MPCNL.Results The preoperative RI of chief renal arteries,intersegmental arteries and interlobar arteries was 0.60±0.13,0.62±0.12 and 0.62±0.16,respectively.One month after operation,the RI was 0.61±0.14,0.61±0.15 and 0.61±0.18,respectively.Three months after operation,the RI was 0.61±0.17,0.61±0.09 and 0.62±0.13,respectively.Preoperative S/D and RI of chief renal arteries,intersegmental arteries and interlobar arteries were not significantly different from postoperative ones（all P0.05）.Conclusion MPCNL has no effect on renal hemodynamics and is a safe operation method for treatment of kidney stones.