不同程度肾积水对肾盂尿流动力学影响的模型研究
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山西省重点研发计划项目(201803D121082),山西医科大学第一医院院精准医疗重点创新培育团队项目(YT1604)


The Influence of Hydronephrosis with Different Degrees on Urodynamics of Renal Pelvis: A Model Study
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    目的 基于计算流体动力学方法,研究不同程度肾积水中尿液的尿流动力学变化,从而评估肾积水程度对肾脏排石能力的影响。方法 建立分支型肾盂A组(正常A1、轻度肾积水A2、中度肾积水A3、重度肾积水A4),成熟壶腹型肾盂B组(正常B1、轻度肾积水B2、中度肾积水B3、重度肾积水B4),胚胎壶腹型肾盂C组(正常C1、轻度肾积水C2、中度肾积水C3、重度肾积水C4)共12个模型,通过计算流体力学计算尿液在肾小盏颈部、肾大盏颈部、肾盂出口处的流速及速度矢量。结果 随着肾积水程度的增加,尿液在肾小盏颈部、肾大盏颈部、肾盂出口处的流速逐渐降低。在肾脏集合系统内的循环停滞区与速度边界层逐渐增大,结石受到的尿液剪切力随之降低,肾脏的排石能力也逐渐下降大。结论 肾积水会导致尿液的尿流动力学发生改变。在临床中选择肾结石治疗方式时,应该充分考虑不同程度肾积水对患者术后排石能力的影响,从而选择更合适的治疗策略。

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    Objective To study urodynamic changes of urine at different degrees of hydronephrosis based on computational fluid dynamics (CFD) method, so as evaluate the influence of hydronephrosis degree on kidneys’ ability to discharge stones. Methods Twelve models, including the branched pelvis Model A (normal hydronephrosis A1, mild hydronephrosis A2, medium hydronephrosis A3, severe hydronephrosis A4 models), mature ampullary pelvis Model B (normal hydronephrosis B1, mild hydronephrosis B2, medium hydronephrosis B3, severe hydronephrosis B4 models), and embryo pot abdominal pelvis Model C (normal hydronephrosis C1, mild hydronephrosis C2, medium hydronephrosis C3, severe hydronephrosis C4 models) were established. The urine flow velocity and velocity vector at the neck of the kidney, the outlet of the renal pelvis were calculated by CFD method. Results As the degree of hydronephrosis increased, the flow velocity of urine at the neck of the kidney and the outlet of the renal pelvis decreased. The urinary shearing force of the stones and the kidney’s ability to discharge stones gradually decreased, whereas the circulatory stagnation zone and the velocity boundary layer in kidney aggregate system gradually increased. Conclusions Hydronephrosis can cause changes in urodynamics of the urine. Therefore, the effect of hydronephrosis with different degrees on the patient’s ability to discharge stones after surgery should be fully considered, so as to choose an appropriate treatment method for kidney stones in clinic.

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秦琪琪,刘凡,段亚余,韩鹏飞,张旭辉.不同程度肾积水对肾盂尿流动力学影响的模型研究[J].医用生物力学,2021,36(6):877-882

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  • 收稿日期:2020-12-14
  • 最后修改日期:2021-01-15
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  • 在线发布日期: 2021-12-23
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