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目的运用彩色多普勒超声(CDU)评价经皮肾镜超声弹道气压碎石术治疗鹿角形肾结石的疗效。方法应用CDU检测35例42个鹿角形肾结石肾脏经皮肾镜超声弹道气压碎石术患者,于手术后3d、7d、1个月观察患肾是否有各种并发症情况以及测量术前术后肾脏肾叶间动脉(IRA)、肾段动脉(SRA)和肾主动脉(MRA)阻力指数RI。结果肾内残留结石及肾积水术后短期内均有较高发生率,观察1个月后发生率大幅减低。肾周积液术后短期内发生率不高,观察1个月后肾周积液发生率大幅减低。肾盏积脓、动静脉瘘、肾微小动脉瘤、胸腔积液、腹腔积液术后短期内发生率较低,观察1个月后消失。在经皮肾镜超声弹道气压碎石术后3d RI均明显增高,术后7d RI逐渐好转,1个月后恢复术前状态。结论 CDU能监测经皮肾镜超声弹道气压碎石术治疗鹿角形肾结石并发症的发生;经皮肾镜超声弹道气压碎石术后鹿角形结石肾出现了短暂肾功能损害,随着时间发展肾功能逐渐好转,直至恢复术前状态。
Objective To evaluate the curative effect of percutaneous nephrolithotracheal lithotripsy in the treatment of antler kidney stones by color Doppler ultrasonography (CDU). Methods 35 cases of 42 deer horns nephrolithiasis patients undergoing percutaneous nephrolithotomy were enrolled in this study. CDS was performed to detect the presence of various complication and to evaluate the effect of preoperative operation on the 3rd, 7th, and 1th month after operation Posterior renal artery (IRA), renal artery (SRA) and renal artery (MRA) resistance index RI. The results of renal residual stones and hydronephrosis after a short period of time have a higher incidence, observed after 1 month the incidence was significantly reduced. The incidence of perirenal effusion short-term after surgery is not high, the observation of 1 month after the incidence of renal effusion significantly reduced. Calyx empyema, arteriovenous fistula, renal micro-aneurysm, pleural effusion, ascites effusion short-term incidence of low, observed after 1 month disappeared. In the percutaneous nephrolithotracheal lithotripsy 3d RI were significantly increased, 7d postoperative RI gradually improved, 1 month after the resumption of preoperative state. Conclusions CDU can monitor percutaneous nephrolithotracheal lithotripsy in the treatment of complications of stagnant nephrolithiasis. Short-term renal dysfunction occurs in anthronal calculi after percutaneous nephrolithotomy, and as time progresses Kidney function gradually improved until the restoration of preoperative state.