Jung H U, Jakobsen J S, Mortensen J, Osther P J, Djurhuus J C
Departments of Urology, Fredericia and Kolding Hospitals, Dronningensgade 97, Fredericia, Denmark.
Scand J Urol Nephrol. 2008;42(1):7-11. doi: 10.1080/00365590701520073. Epub 2007 Sep 6.
Recently, we showed that endoluminally administered isoproterenol (ISO) inhibits muscle function of the pyeloureter in swine. This may be of value in managing increases in pelvic pressure during upper urinary tract endoscopy. The purpose of this study was to examine the effect of endoluminally administered ISO on increases in pelvic pressure and cardiovascular function during flexible ureterorenoscopy.
The study was performed in anaesthetized female pigs. In terms of endoscopic procedures, the pigs were randomized as follows: Group 1, irrigation with 0.1 microg/ml ISO added to saline (n=12); and Group 2, irrigation with saline (n=10). A 5-Fr catheter was retrogradely placed in the renal pelvis and an 8-Fr catheter in the bladder for pressure measurements. Flexible ureterorenoscopy was performed with constant irrigation at a perfusion rate of 8 ml/min. Pelvic, bladder and blood pressure and heart rate were registered continuously.
Mean baseline pelvic pressure was identical in both groups: 12+/-2.3 mmHg in Group 1 and 14+/-3.6 mmHg in Group 2 (p=0.26). During ureterorenoscopy, mean pelvic pressure increased to 26+/-2.3 mmHg in Group 1 and to 38+/-3.1 mmHg in Group 2. Hence ISO reduced the pressure increase due to ureterorenoscopy by 42% (p<0.001). Pelvic pressure seemed to be independent of bladder pressure, which showed no difference between the two groups (p=0.067). Blood pressure and heart rate showed no significant differences between the two groups: p=0.425 and p=0.166, respectively.
ISO (0.1 microg/ml) added to irrigation fluid significantly reduces the increase in pelvic pressure during ureterorenoscopy in pigs, without concomitant side-effects.
最近，我们发现经腔内给予异丙肾上腺素（ISO）可抑制猪肾盂输尿管的肌肉功能。这对于在上尿路内镜检查期间控制盆腔压力升高可能具有重要价值。本研究的目的是探讨在软性输尿管肾镜检查期间经腔内给予ISO对盆腔压力升高和心血管功能的影响。
本研究在麻醉的雌性猪身上进行。在内镜操作方面，将猪随机分为以下两组：第1组，在盐水中添加0.1微克/毫升ISO进行冲洗（n = 12）；第2组，用盐水冲洗（n = 10）。将一根5F导管逆行置入肾盂，一根8F导管置入膀胱以测量压力。以8毫升/分钟的灌注速率持续冲洗进行软性输尿管肾镜检查。连续记录盆腔、膀胱、血压和心率。
两组的平均基线盆腔压力相同：第1组为12±2.3毫米汞柱，第2组为14±3.6毫米汞柱（p = 0.26）。在输尿管肾镜检查期间，第1组的平均盆腔压力升至26±2.3毫米汞柱，第2组升至38±3.1毫米汞柱。因此，ISO使输尿管肾镜检查引起的压力升高降低了42%（p < 0.001）。盆腔压力似乎与膀胱压力无关，两组之间无差异（p = 0.067）。两组之间的血压和心率无显著差异：分别为p = 0.425和p = 0.166。
在冲洗液中添加ISO（0.1微克/毫升）可显著降低猪输尿管肾镜检查期间盆腔压力的升高，且无伴随的副作用。
