| Objective:Based on computational fluid dynamics technology,the urodynamic changes of urine in different degrees of hydronephrosis were studied to evaluate the influence of the degree of hydronephrosis on the ability of kidney stones to be discharged.Methods:Combining the morphological characteristics and measurement data of normal pelvis and calves with light,moderate and severe hydronephrosis in related literature,the CAD software was used to draw the branched renal pelvis A group: normal A1,mild hydronephrosis A2,moderate hydronephrosis A3,and severe hydronephrosis A4;mature ampulla-type renal pelvis B group: normal B1,mild hydronephrosis B2,moderate hydronephrosis B3,severe hydronephrosis B4;embryonic ampulla-type pelvis C group: normal C1,mild hydronephrosis C2,moderate hydronephrosis C3,severe hydronephrosis C4 model.The ICEM CFD software was used to mesh each model separately,and the Fluent 17.0 for hydromechanical was used to analysis of meshed models,and the tecplot 360 ex 2018 r1 software was used to post-process the Fluent simulation results to obtain a visualized image of the hydrodynamic parameters of each model.Data were analyzed using SPSS 17.0 software.Results:1.In the model of group A,the flow velocity of the small kidney and neck was: A1(1.25 ± 0.18),A2(0.98 ± 0.13),A3(0.68 ± 0.06),A4(0.49 ± 0.07),and there were statistically significant differences between the two groups(P <0.05).The flow rates of the kidney and large neck of the kidney were: A1(4.20 ± 0.52),A2(2.35 ± 0.01),A3(1.31 ± 0.03),and A4(0.76 ± 0.03)and the differences between the two groups were statistically significant(P <0.05).The velocity at the exit of the renal pelvis was: A1(10.76 ± 0.04),A2(9.69 ± 0.02),A3(8.66 ± 0.00),A4(8.17 ± 0.04),and the differences between the two groups were statistically significant(P < 0.05).2.In the model of group B,the flow velocity of the small kidney and neck was: B1(1.25 ± 0.18),B2(0.98 ± 0.13),B3(0.67 ± 0.06),and B4(0.48 ± 0.07)and the differences between the two groups were statistically significant(P < 0.05).The flow rates of the kidney and large neck of the kidney were: B1(1.6 ± 0.38),B2(1.28 ± 0.21),B3(0.90 ± 0.08),and B4(0.55 ± 0.05)and the differences between the two groups were statistically significant(P <0.05).The flow velocity at the outlet of the renal pelvis was: B1(10.80 ± 0.05),B2(9.95 ± 0.02),B3(8.67 ± 0.01),and B4(8.08 ± 0.03)and the differences between the two groups were statistically significant(P < 0.05).3.In the model of group C,the flow velocity of the small kidney and neck was: C1(1.15 ± 0.11),C2(0.98 ± 0.13),C3(0.67 ± 0.07),and C4(0.49 ± 0.06)and there were statistically significant differences between the two groups(P <0.05).The velocity at the exit of the renal pelvis was: C1(10.85 ± 0.01),C2(9.85 ± 0.01),C3(8.82 ± 0.01),C4(7.97 ± 0.02)and there were statistically significant differences between the two groups(P <0.05).4.In the A1,B1,and C1 models,there was no significant difference in the urine flow velocity in the neck of the kidneys(P> 0.05).In the A1,B1,and C1 models,the flow velocity of urine in the large neck of kidney was larger in group A1 than in group B1,and the difference was statistically significant(P <0.05).There was no significant difference in the flow velocity of urine at the outlet of the renal pelvis in the A1 and B1 groups(P> 0.05);However,the flow rate of urine at the exit of the renal pelvis is greater in group C1 than in group A1.and the difference was statistically significant(P <0.05).5.The stagnation zone at the urine inlet of the kidney was minimal in A1.With the increase of the degree of hydronephrosis,the renal pelvis and pelvis in A2,A3,and A4 gradually expanded,and the distance between the urine inlet and the tube wall gradually increased,and the circulatory stagnation area at the inlet gradually increased.In addition,due to the gradual decrease of the urine velocity gradient in the four groups of models,the urine flow at the edges was more and more affected by the tube wall,and the velocity boundary layer at the tube wall was also getting thicker.Conclusion:Hydronephrosis can cause the changes in the urodynamics of urine.As the degree of hydronephrosis increases,the flow velocity of urine at the neck of the kidney,the neck of the kidney,and the outlet of the renal pelvis gradually decreases and the circulatory stagnation zone and velocity boundary layer in the kidney aggregate system gradually increase,and the urinary shearing force of the stones decreases,and the kidney's ability to discharge stones gradually decreases.Therefore,when choosing a treatment method for kidney stones in the clinic,the effect of different degrees of hydronephrosis on the patient's ability to discharge stones after surgery should be fully considered,so as to choose a more appropriate treatment strategy. |
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