| 摘要: |
| 目的 探讨超声经皮肾造瘘术治疗肾积水的效果及其用于评价患肾功能的临床价值。 方法 利用超声引导经皮穿刺肾造瘘术对 26 例肾积水患者( 30 例患肾) 进行治疗,超声测量患肾治疗前后肾叶间动脉血流阻力指数及肾实质厚度,术后1周每天记录24小时引流尿量。结果 经皮穿刺肾造瘘术后依据患肾 24 h 引流尿量,分为改善组(22例)及无功能组(8例), 改善组术前肾实质厚度为1.9±0.4cm,无功能组肾实质厚度为1.1±0.2cm,组间具有统计学差异(P<0.01)；改善组术前叶间肾动脉血流RI为0.67±0.07,无功能组肾动脉血流RI为0.8±0.02,组间具有统计学差异(P<0.01)。改善组及无功能组患肾术后肾叶间动脉血流阻力指数均较术前显著降低(P<0.01),肾实质厚度均较术前显著增厚(P<0.01)。结论 超声引导下经皮穿刺肾造瘘术操作简便、小创伤、高疗效,成功率及安全性高,能够准确评估和有效地改善患肾功能,为进一步治疗选择提供一定的参考依据,具有较高的临床应用价值。 |
| 关键词: 肾造瘘术 肾积水 超声引导 叶间动脉阻力指数 |
| DOI： |
| 投稿时间：2016-08-02修订日期：2016-08-02 |
| 基金项目: |
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| Ultrasound-guided percutaneous nephrostomy for the evaluation of renal function improvement |
| SHENG Jianguo,ZHANG Jianquan |
| (Department of Diagnostics Ultrasound,Changzheng Hospital of Second Military Medical University) |
| Abstract: |
| Objective: To explore effect of percutaneous nephrostomy under ultrasound guidance for hydronephrosis and evaluation of the clinical value of renal function. Methods: Twenty six cases (thirty kidney) of hydronephrosis underwent percutaneous nephrostomy(PCN). Ultrasonic measurement of renal vascular resistance index(RI) of the interlobar artery and renal parenchymal thickness were performed before and after PCN treatment, and Urine output were recorded everyday. Results: Patients were divided into the functional improved group (22 cases) and the nonfunctional group (8 cases) accordinig to the daily urine output. The preoperative renal parenchyma thickness of the functional improved group was 1.9±0.4 cm, nonfunctional group was 1.1±0.2 cm, there is statistically difference between the above groups(P < 0.01). The preoperative interlobar artery RI of the functional improved group was 0.67±0.07, nonfunctional group was 0.8±0.02, there is statistically difference between the above groups(P < 0.01). The interlobar artery RI of the two groups were significantly reduced after PCN(P<0.01). The thickness of the renal parenchyma were also significantly thickening after PCN (P < 0.01).Conclusion: PCN can accurately assess and effectively improve the renal function, provide certain reference basis for further treatment options. |
| Key words: percutaneous nephrostomy(PCN) hydronephrosis ultrasound-guided interlobar artery resistance index(RI) |
