Shao Yi, Shen Zhi-Jie, Zhu Yi-Yong, Sun Xiao-Wen, Lu Jun, Xia Shu-Jie
Department of Urology, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, China.
Minim Invasive Ther Allied Technol. 2012 Jul;21(4):302-6. doi: 10.3109/13645706.2011.595419. Epub 2011 Jul 11.
Abstract The objective of the study was to evaluate fluid-electrolyte and renal pelvic pressure (RPP) changes during ureteroscopic lithotripsy. Fifteen patients were detected with residual ureteral calculi after minimally invasive percutaneous nephrolithotomy (MPCNL), distal ureter calculi in three, midureter calculi in four, proximal calculi in eight. RPP was measured via the percutaneous nephrostomy tube by urodynamic study at irrigation pressures of 50, 100 and 200 mmHg. Haemoglobin (Hb), haematocrit (Hct), blood urea mitrogen (BUN), creatinine (Cre), serum sodium (Na(+)), potassium (K(+)), chlorine (Cl(-)) were recorded before and after ureteroscopic lithotripsy. There were no significant differences between Hb, Hct, BUN, Cre, Na(+), K(+), Cl(-) values. Baseline RPP was (16.37 ± 3.14) cmH(2)O, RPPs were 46.06 ± 6.85 cmH(2)O, 99.07 ± 14.62 cmH(2)O and 166.27 ± 33.08 cmH(2)O at irrigation pressures of 50, 100 and 200 mmHg, they were much higher than baseline RPP (p < 0.0001). RPP in the proximal ureter was much higher than in the distal and middle ureter, 50.98 ± 4.52 cmH(2)O versus 40.44 ± 4.07 cmH(2)O (p = 0.0004), 110.26 ± 2.39 cmH(2)O versus 86.29 ± 11.60 cmH(2)O (p = 0.0014), 193.21 ± 5.88 cmH(2)O versus 135.47 ± 20.95 cmH(2)O (p = 0.0002) at irrigation pressures of 50, 100 and 200 mmHg. There were no significant changes in fluid-electrolyte. RPP was significantly increased during ureteroscopic lithotripsy, it was correlated with the irrigation pressure and the position in the ureter.
摘要 本研究的目的是评估输尿管镜碎石术期间的水电解质及肾盂压力（RPP）变化。15例患者在微创经皮肾镜取石术（MPCNL）后检测到残余输尿管结石，其中3例为输尿管下段结石，4例为输尿管中段结石，8例为输尿管上段结石。通过经皮肾造瘘管在50、100和200 mmHg的冲洗压力下进行尿动力学研究测量RPP。在输尿管镜碎石术前和术后记录血红蛋白（Hb）、血细胞比容（Hct）、血尿素氮（BUN）、肌酐（Cre）、血清钠（Na⁺）、钾（K⁺）、氯（Cl⁻）。Hb、Hct、BUN、Cre、Na⁺、K⁺、Cl⁻值之间无显著差异。基线RPP为（16.37±3.14）cmH₂O，在50、100和200 mmHg冲洗压力下的RPP分别为46.06±6.85 cmH₂O、99.07±14.62 cmH₂O和166.27±33.08 cmH₂O，均显著高于基线RPP（p<0.0001）。输尿管上段的RPP显著高于输尿管下段和中段，在50、100和200 mmHg冲洗压力下，分别为50.98±4.52 cmH₂O对40.44±4.07 cmH₂O（p = 0.0004）、110.26±2.39 cmH₂O对86.29±11.60 cmH₂O（p = 0.0014）、193.21±5.88 cmH₂O对135.47±20.95 cmH₂O（p = 0.0002）。水电解质无显著变化。输尿管镜碎石术期间RPP显著升高，与冲洗压力及输尿管内位置相关。
