B型超声联合实时彩色多普勒超声在经皮肾镜取石术中的应用价值

Analysis of the clinical value of B ultrasound combined with real-time color doppler ultrasound in percutaneous nephrolithotomy

目的探讨B型超声(B超)联合实时彩色多普勒超声在经皮肾镜取石术中的应用价值,为临床应用提供指导。方法选择丽水市人民医院2015年12月至2017年12月行经皮肾镜取石术患者150例为观察对象,根据超声引导方式不同分为两组,单纯组70例,应用B超引导穿刺;联合组80例,应用B超联合实时彩色多普勒超声引导穿刺。比较两组并发症发生率、取石成功率,观察联合组患者手术前后肾动脉血流参数[舒张期最低流速(EDV)、收缩期最高流速(PSV)及阻力指数(RI)]的变化。结果联合组并发症发生率为2.50%(2/80),低于单纯组的14.29%(10/70)(χ2=7.046,P<0.05);联合组取石成功率为98.75%(79/80),高于单纯组的85.71%(60/70)(χ2=9.336,P<0.01);联合组患者手术前后肾叶间动脉EDV、PSV差异均有统计学意义(t=3.794、5.385,均P<0.05),RI差异无统计学意义(P>0.05);联合组患者手术前后肾段动脉EDV、PSV差异均有统计学意义(t=4.535、4.884,均P<0.05),RI差异无统计学意义(P>0.05);联合组患者手术前后肾主动脉EDV、PSV差异均无统计学意义(均P>0.05),RI差异有统计学意义(t=4.360,P<0.05)。结论B超联合实时彩色多普勒超声引导用于经皮肾镜取石术,有助于减少并发症的发生,可在一定程度上提高取石成功率。

Objective To explore the application value of B-mode ultrasound combined with real-time color doppler ultrasound in percutaneous nephrolithotomy and provide guidance for clinical application.Methods A total of 150 patients underwent percutaneous nephrolithotomy from December 2015 to December 2017 in the People's Hospital of Lishui were selected.According to different ultrasound guidance methods,the patients were divided into two groups.The single group(70 cases)received B-guided puncture.In the combined group(80 cases),B-ultrasound combined with real-time color doppler ultrasound-guided puncture was applied.The incidence of complications and the success rate of lithotomy were compared between the two groups.The changes in renal artery blood flow parameters[end diastolic velocity(EDV),peak systolic velocity(PSV)and resistance index(RI)]before and after surgery in the combined group were observed.Results The incidence of complications in the combined group was 2.50%(2/80),which was lower than that in the single group[14.29%(10/70)](χ2=7.046,P<0.05).The success rate of stone extraction in the combined group was 98.75%(79/80),which was higher than that in the single group[85.71%(60/70)](χ2=9.336,P<0.01).The EDV and PSV of the renal interlobar arteries of the combined group before and after surgery had statistically significant differences(t=3.794,5.385,all P<0.05),but the RI had no statistically significant difference(P>0.05).The EDV and PSV of renal segment arteries in the combined group before and after surgery had statistically significant differences(t=4.535,4.884,all P<0.05),while the RI had no statistically significant difference(P>0.05).The EDV and PSV of renal aorta of the combined group before and after surgery showed no statistically significant differences(all P>0.05),while the RI showed statistically significant difference(t=4.360,P<0.05).Conclusion B-mode ultrasound combined with real-time color doppler ultrasound guidance for percutaneous nephrolithotomy can help reduce the incidence of complications and improve the success rate of stone extraction to a certain extent.