双能量CT灌注成像对体外冲击波治疗肾结石前后肾功能改变的评估

发布时间：2018-01-19 12:05

本文关键词： 体外冲击波碎石术血流动力学 CT灌注成像　出处：《遵义医学院》2013年硕士论文　论文类型：学位论文

【摘要】：目的：研究肾结石患者经不同能量的冲击波碎石治疗后,患者肾血流的近期变化,并探讨体外冲击波碎石治疗最优能量。方法：本研究共收集29例肾结石患者,共分为两组,分别用9-10KV(19例)、10-11KV(10例)进行体外冲击波治疗,并在治疗前即时、后24-72小时行双能量多层螺旋CT灌注扫描,监测患者肾脏各项灌注参数,并同时监测治疗前后血肌酐、尿素氮等参数变化。结果：肾结石患者碎石前、后肾脏结石周围区域(能量冲击中心区域)各项灌注参数MIP、血流量(BF)、血容量(BV)、造影剂达峰时间(TTP)、毛细血管表面通透性(PS)及平均通过时间(MTT)均存在统计学差异,P0.05；远结石区域治疗前、后各项灌注参数无统计学差异,P0.05。治疗前、后血肌酐、尿素氮无统计学差异,P0.05。结论：本研究表明CT灌注成像各项血流动力学参数变化可用于评估体外冲击波碎石治疗前、后肾功能的变化,且血流灌注参数变化早于血肌酐、尿素氮等变化。此外,本研究证实9-10KV、10-11KV为肾结石体外冲击波治疗的安全能量。
[Abstract]:Objective: to study the short-term changes of renal blood flow in patients with renal calculi treated with shock wave lithotripsy with different energy, and to explore the optimal energy of extracorporeal shock wave lithotripsy (ESWL). Methods: a total of 29 patients with renal calculi were divided into two groups. The patients were treated with extracorporeal shock wave (ESWL) from 9 to 10 KV (n = 19). The perfusion parameters of kidney were monitored by dual-energy multi-slice spiral CT perfusion scan at 24-72 hours after treatment. The changes of serum creatinine and urea nitrogen were also monitored before and after treatment. Results: before and after renal stone lithotripsy, the perfusion parameters of the surrounding area (energy shock center area) of renal calculi were MIP, blood flow volume (BFU), blood volume (BV). There were significant differences in peak time (TTPN), capillary surface permeability (PSV) and mean transit time (MTT) between two groups (P 0.05). There was no significant difference in the parameters of perfusion before and after treatment for distal calculi (P 0.05). There was no significant difference in serum creatinine and urea nitrogen (P 0.05) before and after treatment. Conclusion: this study shows that the changes of hemodynamic parameters in CT perfusion imaging can be used to evaluate the changes of renal function before and after extracorporeal shock wave lithotripsy, and the changes of perfusion parameters are earlier than those of serum creatinine. In addition, 9-10 KV 10-11 KV was proved to be a safe energy for extracorporeal shock wave therapy of renal calculi.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.7;R692.4

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