微创治疗尿路结石后的肾脏血流动力学评估方法

I. M. Kholimenko, S. P. Seregin, S. N. Rodionova, A. V. Pugzhilis
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摘要

研究目的在所有泌尿系统疾病中,尿路结石是仅次于感染性和炎症性疾病的主要疾病。/此外,该病的相关性并没有因为患者人数的不断增加而减弱。本研究旨在研究微创方法治疗尿路结石远程冲击波碎石术(DLТ)和经皮肾镜碎石术(РNL)后肾血流动力学变化的特殊性,以提高泌尿科患者的医疗质量。大量研究详细显示了使用远程冲击波碎石和经皮肾镜碎石治疗肾结石的有效性。这些方法创伤小,患者耐受性好,减少了并发症的风险,但同时也会造成肾损伤,尤其是微循环障碍。使用多普勒检查法可以对肾脏微循环受损程度进行信息量很大的评估,用于诊断尿路结石,包括微创治疗方法后的血液动力学评估。研究结果表明,在远程冲击波碎石术和经皮肾镜碎石术后使用多普勒肾血管造影术时,DLТ术后第一天的动态血流动力学就会出现异常。此外,与РNL术后的血液动力学相比,指标正常化的时间更长。此外,使用РNL后,术后动态血流指标会逐渐增加。该研究表明,超声多普勒检查是动态评估肾血流的有效方法,肾损伤的指标是阻力指数,主要是小叶间动脉的阻力指数。
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Methods for Assessing Renal Нemodynamics after Minimally lnvasive Treatment of Urolithiasis
The purpose of research. Urolithiasis occupies a leading place among all urological diseases after infectious and inflammatory ones. /n addition, it does not lose its relevance due to the fact that the number of patients with this disease is steadily increasing. Тhe aim of the study is to study the peculiarities of changes in renal hemodynamics after minimally invasive methods of treatment of urolithiasis remote shock wave lithotripsy (DLТ) and percutaneous nephrolithotripsy (РNL) to improve the quality of medical care for urological patients.Methods. Numerous studies have shown in detail the effectiveness of using remote shock wave lithotripsy and percutaneous nephrolithotorypsy in the treatment of kidney stones. Тhese methods are minimally invasive, well tolerated by patients, and reduce the risks of complications, but they are accompanied by kidney injury, in particular, microcirculation disorders. Тhe use of the Dopplerographic method of investigation allows for a highly informative assessment of the degree of impaired renal microcirculation for the diagnosis of urolithiasis, including for the assessment of hemodynamics after minimally invasive treatment methods.Results. Тhe work shows that when using dopplerography of renal vessels after remote shock wave lithotripsy and percutaneous nephrolithotorypsy, a violation of hemodynamics after DLТ is noted in dynamics already on the first day. In addition, the terms of normalization of indicators are longer in comparison with hemodynamics after РNL. Аlso, with РNL, there is a gradual increase in blood flow indicators in the dynamics of the postoperative period.Conclusion. Тhe work shows that ultrasound Dopplerography is an effective method of dynamic assessment of renal blood flow, and the indicator of renal damage is the resistance index, mainly in the interlobular arteries.
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