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[引流液中肌酐的测定。尿漏还是淋巴囊肿?]

[Determination of creatinine in drained liquid. Urinary leak or lymphocele?].

作者信息

Flores-Gama Francisco, Bochicchio-Riccardelli Tommaso, Mondragón-Ramírez Guillermo

机构信息

Servicio de Cirugía de Trasplante, Instituto Mexicano de Transplantes, Cuernavaca, Morelos, Mexico.

出版信息

Cir Cir. 2010 Jul-Aug;78(4):327-32.

Abstract

BACKGROUND

Liquid collections around the renal graft that are displayed in 51% of cases implicate a diagnostic challenge and a risk for graft function. We undertook this study to determine the usefulness of creatinine concentration measurement in drainage in patients with renal transplantation.

METHODS

We selected patients with surgically corrected urinary leak and patients with lymphocele from November 1, 1999, to November 30, 2008, in whom we determined the creatinine concentration in liquid drainage, plasma and urine.

RESULTS

We included five patients with urinary leak and six patients with lymphocele. Two patients had urinary leak before the lymphocele. The t value of the plasma creatinine (Pcreat), drainage (Dcreat) and urine (Ucreat) was 0.89, 0.045 and 0.63, respectively. The diagnostic criteria of urinary leak represented a value between the creatinine of the drainage and plasma (D/Pcreat) >6, between urine and drainage (U/Dcreat) <3 and between urine and plasma (U/ Pcreat) <7. When we compared both groups the χ(2) values were 0.018, 0.007 and 0.094, respectively.

CONCLUSIONS

There is a statistically significant difference among the creatinine drainage liquid values. Our study shows that D/Pcreat ratio >6 after the first week or U/Dcreat ratio <3 at any time during the postoperative period represents a six-times higher possibility of urinary leak.

摘要

背景

肾移植术后出现液体聚集的情况在51%的病例中可见,这给诊断带来挑战,并对移植肾功能构成风险。我们开展这项研究以确定测量肌酐浓度在肾移植患者引流液中的作用。

方法

我们选取了1999年11月1日至2008年11月30日期间接受手术纠正尿漏的患者和淋巴管囊肿患者,测定其引流液、血浆和尿液中的肌酐浓度。

结果

我们纳入了5例尿漏患者和6例淋巴管囊肿患者。2例患者在出现淋巴管囊肿之前就有尿漏。血浆肌酐(Pcreat)、引流液肌酐(Dcreat)和尿液肌酐(Ucreat)的t值分别为0.89、0.045和0.63。尿漏的诊断标准为引流液与血浆肌酐之比(D/Pcreat)>6、尿液与引流液肌酐之比(U/Dcreat)<3以及尿液与血浆肌酐之比(U/Pcreat)<7。当我们比较两组时,χ(2)值分别为0.018、0.007和0.094。

结论

肌酐引流液值之间存在统计学上的显著差异。我们的研究表明,术后第一周后D/Pcreat比值>6或术后任何时间U/Dcreat比值<3提示尿漏的可能性高出6倍。

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