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目的 :探讨多普勒肾血流检测在儿童肾梗阻的病理生理学意义及临床应用价值。方法 :用多普勒超声检测 9例肾盂积水患儿主肾动脉、段动脉及叶间动脉的多普勒血流频谱。检测指标为收缩期最大峰值流速 (Vmax)、舒张末最低流速 (Vmin)、 Vmax/ Vmin、 (S/ D)、阻力指数 (RI)、脉动指数 (PI)及△ RI。健康学龄儿童对照 30例。结果 :30例正常学龄儿童多普勒肾血流频谱呈高速低阻型 ,9例梗阻性肾盂积水多普勒肾血流频谱呈低速高阻型 ,三级肾动脉 RI、 PI及 S/ D较正常对照明显升高 ,Vmax及 Vmin降低 (P<0 .0 1) ,6例单侧梗阻两肾间△ RI较正常明显升高。结论 :肾盂内压对肾血流阻力产生影响。多普勒超声检测肾血流 RI、 PI、 S/ D及△ RI为儿童肾梗阻的诊断和鉴别诊断提供了一种简便有效的新方法
Objective: To investigate the pathophysiological significance and clinical value of Doppler renal blood flow in children with renal obstruction. Methods: Doppler ultrasound was used to detect Doppler flow spectrum of the main renal artery, segmental artery and interlobar artery in 9 patients with hydronephrosis. The indexes of detection were Vmax, Vmin, Vmax / Vmin, (S / D), resistance index (RI), pulsatility index (PI) and △ RI. Healthy school-age children control 30 cases. Results: The Doppler renal blood flow spectrum of 30 normal school children showed a high-speed and low-resistance type. The Doppler renal blood flow spectrum of 9 patients with obstructive hydronephrosis was low-speed and high-resistance. RI, PI, S / D was significantly higher than that of the normal control, Vmax and Vmin were decreased (P <0.01), and △ RI of two unilateral obstruction in 6 cases was significantly higher than that of normal control. Conclusion: Intra-renal pelvic pressure has an effect on renal blood flow resistance. Doppler ultrasound detection of renal blood flow RI, PI, S / D and △ RI provides a convenient and effective new method for the diagnosis and differential diagnosis of renal obstruction in children