彩色超声多普勒在输尿管结石伴肾盂积水治疗中的临床应用

Clinical application of color Doppler of ultrasonography in the treatment of ureteral calculus with hydronephrosis

目的 探讨彩色多普勒在输尿管结石伴肾盂积水治疗中的临床应用价值。方法 检测 42只输尿管结石伴肾盂积水采用输尿管切开取石术前的肾内血流动力学指标 ,并与术后 1 5d、1月、3月检测的肾内血流动力学指标相比较 ,观察其变化情况并与术后肾功能恢复情况相联系 ,了解其相关性。结果 36只输尿管结石伴肾盂轻中度积水肾内血管彩色血流信号欠丰富 ,主肾动脉峰值流速 (Vmax)和肾脏血流量 (CO)明显低于对侧正常组 (P <0 0 5) ,RI值两者无显著性差异 (P >0 0 5)。 6只输尿管结石伴肾盂重度积水肾内血管彩色血流信号显示稀疏或缺乏 ,Vmax和CO也明显低于对侧正常 ,但RI值升高 ,与对侧正常比较差异显著 (P<0 0 5)。手术后肾内彩色血流信号、Vmax和CO与术前比较有明显改善 (P <0 0 5) ,重度积水者其RI值恢复至正常范畴。结论 彩色多普勒在手术前即能判断患侧肾功能 。

Objective To investigate the clinical value of color Doppler of Ultrasound (CDU) in the treatment of ureteral calculus with hydronephrosis. Methods The hemodynamic parameters of the kidney for 42 cases of ureteral calculus with hydronephrosis were determined with CDU before operation, and at the 15th day, 1 and 3 month after operation. The relationship of the alteration of hemodynamic parameters with the recovery of renal function after operation was analyzed. Results The signal of 36 cases of ureteral calculus with mild or moderate hydronephrosis showed not rich in intra kidney blood flow. The maximal flow velocity of main renal artery and renal blood flow were significantly lower than the normal kidney ( P <0.05). There was no significant difference in resistance index between 2 sides. Six cases of ureteral calculus with severe hydronephrosis showed little blood flow signal or no signal. The maximal flow velocity of main renal artery and renal blood flow were also significantly lower than the normal side, but the resistance index was significantly higher than the opposite( P <0.05). After operation, the blood flow signal, the maximal flow velocity, and the renal blood flow were obviously improved( P <0.05), the resistance index of the patients with severe hydrops was restored to the normal level. Conclusion CDU can be used to judge the renal function of illed kidney before operation, and can predict the post operative prognosis rather precisely.