重症肾脏超声对围术期急性肾损伤预测及评估的研究进展

Research advances of severe renal ultrasound assessment of perioperative period acute renal injury

中文关键词: 急性肾损伤  重症超声  肾阻力指数  肾动脉搏动指数  静脉阻力指数

英文关键词: Acute kidney injury  Severe ultrasound  Renal resistance index  Renal artery pulsatility index  Vein resistance index

中文摘要:

      肾脏可因灌注不足、氧供需失衡、机械通气和手术刺激等一系列病理生理改变，最终导致围术期急性肾损伤（AKI）。AKI是围术期发生率较高的一种术后并发症。因此，预测和评估围术期AKI的发生发展对患者的肾脏保护和预后改善有着极其重要的意义。重症肾脏超声可以无创地评估肾脏结构的形态学变化，肾内肾外血管的形态以及肾内血流动力学，其中肾脏阻力指数（RRI）、肾动脉搏动指数（RPI）、静脉阻力指数（VII）广泛用于AKI的预测和评估，尤其是对重症患者AKI的动态监测发挥着重要作用。本文章将从AKI的定义、围术期AKI的预测与评估进展、重症肾脏超声对围术期AKI的预测和评估进展三方面进行描述。

英文摘要:

      A series of pathophysiological changes can occur in the kidney due to insufficient perfusion, imbalance between oxygen supply and demand, mechanical ventilation and surgical stimulation, which eventually lead to perioperative acute renal injury (AKI). AKI is a postoperative complication with a high incidence during the perioperative. Therefore, predicting and evaluating the occurrence and development of perioperative AKI is of great significance for renal protection and improving prognosis. Severe renal ultrasound can noninvasively evaluate the morphological changes of renal structure, the morphology of intrarenal and extrarenal vessels and intrarenal hemodynamics. Among them, renal resistance index (RRI), renal pulsatility index (RPI) and venous impedance index (VII) are widely used in the prediction and evaluation of AKI, especially for the dynamic monitoring of AKI in critically ill patients. This article will describe the definition and progress of AKI, the prediction and evaluation progress of perioperative AKI and the prediction and evaluation progress of perioperative AKI with renal ultrasound.