彩色多普勒超声评价经皮肾镜超声弹道气压碎石术前后肾功能的变化
|
摘要
目的探究彩色多普勒超声评价经皮肾镜超声弹道气压碎石术前后肾功能的变化。方法选取100例行经皮肾镜超声弹道气压碎石术的患者,运用彩色多普勒超声对其手术前后的肾实质厚度、肾动脉的阻力指数(RI)以及肾集合系统分离度进行检查,依据患者在术前和术后肾小球滤过率(GFR)将其分成A、B、C、D四组,分别代表肾无功能、肾功能显著改善、肾功能显著减退以及肾功能无显著改善。对患者的肾实质厚度、RI以及肾集合系统分离度进行对比,分析相关性。结果各组患者上述指标在术前术后其差异具有统计学意义(P<0.05)。患者的GFR与肾实质厚度呈显著正相关(P<0.05),而肾集合系统的分离程度和RI则与GFR呈显著负相关(P<0.05)。确诊肾脏无功能:实质厚度小于0.32 cm,患者的肾集合系统分离程度大于4.27 cm、IRA RI大于0.8,敏感度达到92.0%,特异度达到96.0%;IRA RI小于0.72诊断肾脏功能改善,患者敏感度低于86.0%,特异度为低于84.0%。结论在对患者经皮肾镜超声弹道气压碎石术的疗效评价中,以患者的肾实质厚度小于0.32 cm、肾集合系统分离程度大于4.27 cm、IRA大于0.8且IRA RI小于0.72作为参考指标。
Objective To investigate how to evaluate renal function changes before and after percutaneous nephrolithotomy(PCNL) combined with pneumatic and ultrasonic lithotripsy by means of color-Doppler ultrasonography(CDU). Methods 100 patients who underwent percutaneous nephrolithotomy(PCNL) combined with pneumatic and ultrasonic lithotripsy were enrolled in the study. Color Doppler ultrasonography was used to determine the renal parenchyma thickness, renal artery resistance index(RI), and separation distance of renal collecting system before and after the operation. Based on the changes of glomerular filtration rate(GFR) of the patients before and after the operation, the patients were divided into four groups A, B, C, and D, which mean renal nonfunction, significant improvement in renal function, significant degradation of renal function, and no significant improvement of renal function respectively. Comparison of the renal parenchyma thickness, RI, and separation distance of renal collecting system was made and correlation was analyzed. Results The differences of the above indexes of the patients before and after operation were statistically significant(P<0.05). There was a significant positive correlation between GFR and renal parenchyma thickness(P<0.05), while the separation distance of renal collecting system and RI were significantly negatively correlated with GFR(P< 0.05). The indexes of confirmed renal nonfunction were as follows: renal parenchymal thickness was less than 0.32 cm, and the separation distance of the renal collecting system of the patient was greater than 4.27 cm. IRA RI was greater than 0.8, sensitivity was up to 92.0% and specificity was up to 96.0%. The indexes indicating renal function improvement were as follows: IRA RI was less than 0.72, sensitivity was less than86.0%, and specificity was less than 84.0%. Conclusion As for the evaluation of therapeutic effects of percutaneous nephrolithotomy(PCNL) combined with pneumatic and ultrasonic lithotripsy, the following indexes can be used as reference indexes: renal parenchyma thickness of less than 0.32 cm, the separation distance of renal collecting system of greater than 4.27 cm, the IRA of greater than 0.8 and the IRA RI of less than 0.72.
Objective To investigate how to evaluate renal function changes before and after percutaneous nephrolithotomy(PCNL) combined with pneumatic and ultrasonic lithotripsy by means of color-Doppler ultrasonography(CDU). Methods 100 patients who underwent percutaneous nephrolithotomy(PCNL) combined with pneumatic and ultrasonic lithotripsy were enrolled in the study. Color Doppler ultrasonography was used to determine the renal parenchyma thickness, renal artery resistance index(RI), and separation distance of renal collecting system before and after the operation. Based on the changes of glomerular filtration rate(GFR) of the patients before and after the operation, the patients were divided into four groups A, B, C, and D, which mean renal nonfunction, significant improvement in renal function, significant degradation of renal function, and no significant improvement of renal function respectively. Comparison of the renal parenchyma thickness, RI, and separation distance of renal collecting system was made and correlation was analyzed. Results The differences of the above indexes of the patients before and after operation were statistically significant(P<0.05). There was a significant positive correlation between GFR and renal parenchyma thickness(P<0.05), while the separation distance of renal collecting system and RI were significantly negatively correlated with GFR(P< 0.05). The indexes of confirmed renal nonfunction were as follows: renal parenchymal thickness was less than 0.32 cm, and the separation distance of the renal collecting system of the patient was greater than 4.27 cm. IRA RI was greater than 0.8, sensitivity was up to 92.0% and specificity was up to 96.0%. The indexes indicating renal function improvement were as follows: IRA RI was less than 0.72, sensitivity was less than86.0%, and specificity was less than 84.0%. Conclusion As for the evaluation of therapeutic effects of percutaneous nephrolithotomy(PCNL) combined with pneumatic and ultrasonic lithotripsy, the following indexes can be used as reference indexes: renal parenchyma thickness of less than 0.32 cm, the separation distance of renal collecting system of greater than 4.27 cm, the IRA of greater than 0.8 and the IRA RI of less than 0.72.
引文
[1]孙萌,孟贺,张树华,等.彩超对经皮肾镜超声弹道气压碎石术治疗不同肾功能肾脏的血流动力学观察[J].中国煤炭工业医学杂志,2013,16(6):870-873.
[2]孙萌,孟贺,马琳,等.彩色多普勒超声评价经皮肾镜超声弹道气压碎石术前后肾功能的变化[J].中国医学影像学杂志,2013,21(10):754-757.
[3]孙萌,孟贺,马琳,等.彩色多普勒超声对经皮肾镜超声弹道气压碎石术前后积水肾脏血流灌注变化评估价值[J].中国全科医学,2013,16(15):1812-1815.
[2]孙萌,孟贺,马琳,等.彩色多普勒超声评价经皮肾镜超声弹道气压碎石术前后肾功能的变化[J].中国医学影像学杂志,2013,21(10):754-757.
[3]孙萌,孟贺,马琳,等.彩色多普勒超声对经皮肾镜超声弹道气压碎石术前后积水肾脏血流灌注变化评估价值[J].中国全科医学,2013,16(15):1812-1815.