Suppr超能文献

经输尿管镜碎石取石术后梗阻的无创评估:肾阻力指数评估的作用。

Non-invasive evaluation of obstruction after ureteroscopic stone removal: Role of renal resistive index assessment.

机构信息

Health Sciences University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul.

出版信息

Arch Ital Urol Androl. 2020 Oct 2;92(3). doi: 10.4081/aiua.2020.3.244.

Abstract

OBJECTIVES

The aim of this study is to evaluate prediction of postoperative ureteral obstruction needing ureteral stent insertion by evaluating the resistive index (RI) values and the grade of hydronephrosis.

MATERIAL AND METHODS

A total of 66 adult patients undergoing stentless endoscopic ureteral stone treatment (URS) between January 2018 and January 2019 were included in this prospective study. Preoperative patient and stone characteristics were noted. All patients were evaluated with renal Doppler ultrasonography study to assess degree of hydronephrosis and RI values. A renal Doppler ultrasonography was repeated at postoperative 1st, 3rd and 7th days. Changes in both RI and hydronephrosis levels before and after the procedures were noted. On the postoperative 7th day, patients were divided into two groups including obstructive and non-obstructive cases according to RI values assessed where a RI value of 0.7 was accepted as the cut-off for obstruction. The preoperative and perioperative characteristics of both groups were evaluated in a comparative manner.

RESULTS

The mean patient age was 43.6 ± 1.72 years. Significant improvements were noted in RI and grade of hydronephrosis after the operation. The grade of hydronephrosis and RI values were found to improve more significantly on postoperative 3rd day when compared to the postoperative 7th day (p < 0.01 and p < 0.01). A significant correlation was detected between the grade of hydronephrosis (>grade 2) and obstructive RI values (> 0.7) in each postoperative visits (p: 0.001). RI values (> 0.7) at postoperative seventh days were correlated with larger mean stone size, increased ureteral wall thickness, increased diameter of the ureter proximal to the stone, and longer duration of the operation. Preoperative high-grade hydronephrosis indicated obstructive RI values at postoperative seventh day (p = 0.001) Conclusion: Changes in RI values on Doppler sonography and the grade of hydronephrosis may be a guiding parameter in assessing postoperative ureteral obstruction.

摘要

目的

本研究旨在通过评估阻力指数(RI)值和肾积水程度,预测需要输尿管支架置入的术后输尿管梗阻。

材料和方法

本前瞻性研究纳入了 2018 年 1 月至 2019 年 1 月期间接受无支架内镜下输尿管结石治疗(URS)的 66 例成年患者。记录患者术前的一般资料和结石特征。所有患者均接受肾脏多普勒超声检查以评估肾积水程度和 RI 值。术后第 1、3、7 天行肾脏多普勒超声复查。记录手术前后 RI 值和肾积水程度的变化。术后第 7 天,根据 RI 值将患者分为梗阻组和非梗阻组,其中 RI 值为 0.7 被认为是梗阻的截断值。比较两组患者的术前和围手术期特征。

结果

患者平均年龄为 43.6±1.72 岁。术后 RI 值和肾积水程度均显著改善。与术后第 7 天相比,术后第 3 天肾积水程度和 RI 值改善更为显著(p<0.01 和 p<0.01)。在每个术后访视中,均检测到肾积水程度(>2 级)和梗阻性 RI 值(>0.7)之间存在显著相关性(p:0.001)。术后第 7 天 RI 值(>0.7)与结石平均直径较大、输尿管壁厚度增加、结石近端输尿管直径增加和手术时间延长相关。术前重度肾积水预示着术后第 7 天存在梗阻性 RI 值(p=0.001)。结论:多普勒超声检查 RI 值和肾积水程度的变化可能是评估术后输尿管梗阻的一个指导参数。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验