经皮肾镜手术前后肾阻力指数变化在肾功能中的应用评价

Study of renal resistance index for evaluating renal function before and after percutaneous nephroscopic operation

目的应用经皮肾镜手术前后肾阻力指数(RI)的变化来评价肾功能。方法采用随机、平行对照的临床研究方法,对纳入本研究的40例患者,记录经皮肾镜手术前、手术后0.5 h、手术后2周时双侧肾上、中、下段肾叶间动脉阻力指数,以及血液肌酐、尿素氮数据,分析肾动脉阻力指数与肾功能变化的关系。结果 1患侧肾在经皮肾镜术前2 h与术后0.5 h叶间动脉RI值相比较,差异有统计学意义(t=2.72,P<0.05),术后1周的叶间动脉RI值相比较,差异有统计学意义(t=3.57,P<0.05),而健侧肾在经皮肾镜术前与术后0.5 h叶间动脉RI值相比,差异无统计学意义(t=1.63,P>0.05),而与术后2周叶间动脉RI值相比,差异有统计学意义(t=3.31,P<0.05);2患者的术前2 h血液中肌酐与术后0.5 h相比,差异无统计学意义(t=1.33,P>0.05),而与术后1周相比,差异有统计学意义(t=3.86,P<0.05),患者的术前2 h血液中尿素氮与术后0.5 h相比,差异无统计学意义(t=2.01,P>0.05),而与术后1周相比,差异有统计学意义(t=3.57,P<0.05);3患者健侧肾术前、术后RI值与肌酐、尿素氮变化无相关性,而患侧肾术前、术后RI值与肌酐、尿素氮的变化呈负相关(r=-0.37,P<0.05)。结论可以应用经皮肾镜手术前后肾RI的变化来评价肾功能的变化,为泌尿科微创取石手术提供临床依据。

Objective Application of the change of renal resistive index before and after percutaneous nephro-scopic operation to evaluate renal function. Methods Based on random, parallel control as clinical research methods, to review 40 patients who underwent artery resistance index record percutaneous nephrolithotomy before operation, and 0.5 h, 2 weeks after operation of bilateral kidney, renal interlobar arteries resistance index （RI） and serum creati-nine, urea nitrogen data, and analyse the relationship between change index and renal function of renal artery resis-tance. Results ①Compare interlobar artery RI of kidney after half an hour of percutaneous nephrolithotomy and pre-operative two hours, the difference was statistically significant （t=2.72, P〈0.05）, postoperative one week of interlobar artery RI was compared, the difference was statistically significant （t=3.57, P〈0.05）, and interlobar artery RI value of healthy kidneys was compared before and half an hour after percutaneous nephrolithotomy, and the difference was not statistically significant （t=1.63, P〉0.05）. Compare the RI value after two weeks of interlobar arteriesthe, and the dif-ference was statistically significant （t=3.31, P〈0.05）. ②Serum creatinine in the blood after comparation in the preop-erative 2 h and postoperative 0.5 h has no significant difference （t=1.33, P〉0.05）, and when compared with one week after operation, the difference was statistically significant （t=3.86, P〈0.05）. ③ Compare the blood urea nitrogen for preoperative two hours with half of hour after the operation,there was no significant difference （t=2.01, P〉0.05）. Com-pare the blood urea nitrogen for preoperative two hours with one week after operation, the difference was statistically significant （t=3.57, P〈0.05）. The RI value of patients′healthy kidney for preoperative and postoperative had no corre-lation with serum creatinine, urea nitrogen, while RI for preoperative and postoperative was negatively correlated with serum creatinine and urea nitrogen change （r=-0.37, P〈0.05）. Conclusion The change before and after percutaneous nephroscopic operation of renal resistive index can evaluate renal function, providing the basis for urological minimal-ly invasive stone operation.