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目的探讨多普勒超声肾内阻力指数和阻力指数差在诊断单侧梗阻性肾积水及对积水肾功能可复性评估的临床应用价值。方法用多普勒超声检测53例单侧梗阻性肾积水患者主肾动脉、肾段动脉及叶间动脉的多普勒频谱,检测指标为收缩期最大峰值流速(Vmax)、舒张末最低流速(Vmin)、阻力指数(RI)、波动指数(PI)和阻力指数差(ΔRI),并且进行术前、术后3个月和6个月的动态观察,同时分静脉尿路造影(IVU)对比。正常对照组36例。结果53例单侧梗阻性肾积水患者中,轻度肾积水、中度肾积水和重度肾积水的RI及ΔRI均升高,以中度肾积水和重度肾积水更为显著(P<0.01),轻度肾积水ΔRI较RI更具有显著性;动态观察RI和ΔRI进行性下降。结论RI和ΔRI为单侧梗阻性肾积水的诊断及积水肾功能的可复性评估提供了一种简便有效的方法。
Objective To investigate the clinical value of Doppler ultrasound in the evaluation of renal resistance index and resistance index difference in the diagnosis of unilateral obstructive hydronephrosis and refolding of hydronephrosis. Methods The Doppler spectrum of the main renal artery, renal arteries and interlobar arteries in 53 patients with unilateral obstructive hydronephrosis was detected by Doppler echocardiography. The indexes of detection were maximum peak systolic velocity (Vmax), minimum end diastolic velocity (Vmin), resistance index (RI), fluctuating index (PI) and resistance index difference (ΔRI), and dynamic observation of preoperative, postoperative 3 months and 6 months, while intravenous urography (IVU) Compared. 36 cases of normal control group. Results In 53 patients with unilateral obstructive hydronephrosis, the RI and ΔRI in mild hydronephrosis, moderate hydronephrosis, and severe hydronephrosis were both higher than those in moderate hydronephrosis and severe hydronephrosis Significantly (P <0.01), mild hydronephrosis ΔRI more significant than RI; dynamic observation of RI and ΔRI decreased. Conclusion RI and ΔRI provide a simple and effective method for the diagnosis of unilateral obstructive hydronephrosis and the renaturation assessment of hydronephrosis.