Balawender Krzysztof, Orkisz Stanisław
Morphological Science Department of Human Anatomy, Medical Faculty University of Rzeszów, Poland.
Department of Urology, Pope John Paul II Regional Hospital in Zamość, Poland.
Cent European J Urol. 2017;70(3):264-269. doi: 10.5173/ceju.2017.1243. Epub 2017 Jul 4.
Despite the risk of complications, which does not exceed several percent, extracorporeal shock wave lithotripsy (ESWL) causes morphological and functional changes in kidneys as a result of the effect of the generated shock wave energy on the renal parenchyma structure.
Forty-two patients were included in the study. The mean age in the studied group was 50.9 years (SD ±13.7). Extracorporeal lithotripsy treatments were carried out during the period from January 2014 to April 2014 using an electromagnetic shock wave generator. The spectrum of blood flow of the interlobar arteries of both the treated and the opposite kidney was investigated. On the basis of these spectrums, parameters such as: resistive index (RI), pulsatility index (PI) and acceleration time (AT) were calculated.
The ESWL treatment causes a statistically significant increase of the RI parameter in the ipsilateral kidney (p <0.0001) as well as in the opposite kidney (p <0.0001). The RI value decreases after 92 hours after the treatment, reaching statistical significance in both kidneys (p <0.005). The PI parameter substantially increases after treatment in both kidneys (p <0.0001), and decreases after 92 hours (p <0.0001). Statistically significant correlations are shown between RI as well as the PI parameters and the patient's age.
Extracorporeal shock wave lithotripsy (ESWL) of renal stones causes temporary impairment of the renal perfusion in both ipsilateral and contralateral kidneys. The main factor that determines the value of the RI and PI parameters is the patient's age.
尽管存在并发症风险(不超过百分之几),但体外冲击波碎石术(ESWL)会因所产生的冲击波能量对肾实质结构的影响,而导致肾脏出现形态和功能变化。
42例患者纳入本研究。研究组的平均年龄为50.9岁(标准差±13.7)。2014年1月至2014年4月期间,使用电磁冲击波发生器进行体外碎石治疗。对治疗侧肾脏和对侧肾脏的叶间动脉血流频谱进行研究。基于这些频谱,计算诸如阻力指数(RI)、搏动指数(PI)和加速时间(AT)等参数。
ESWL治疗导致同侧肾脏(p<0.0001)以及对侧肾脏(p<0.0001)的RI参数出现统计学显著升高。治疗后92小时,RI值下降,在两个肾脏中均达到统计学显著水平(p<0.005)。治疗后两个肾脏的PI参数均大幅升高(p<0.0001),92小时后下降(p<0.0001)。RI和PI参数与患者年龄之间呈现出统计学显著相关性。
肾结石的体外冲击波碎石术(ESWL)会导致同侧和对侧肾脏的肾灌注出现暂时受损。决定RI和PI参数值的主要因素是患者年龄。