Woodbury P W, Mitchell M E, Scheidler D M, Adams M C, Rink R C, McNulty A
James Whitcomb Riley Hospital for Children, Indianapolis, Indiana.
J Urol. 1989 Aug;142(2 Pt 2):632-5; discussion 667-8. doi: 10.1016/s0022-5347(17)38840-7.
In an effort to define a more physiological method to determine obstruction in the upper urinary tract, the technique of constant pressure perfusion was studied in the canine and porcine models. In contrast to the constant flow technique of Whitaker, constant pressure perfusion is independent of upper tract compliance, uses low fixed pressures (7 to 12 cm. water) in the renal pelvis and measures flow rates from the upper tracts. In the canine and porcine models constant pressure perfusion demonstrated increased sensitivity and better discrimination between normal and partially obstructed systems relative to constant flow. Pressures in nonobstructed canine and porcine renal pelves are normally low (less than 8 cm. water) for flow rates into the bladder of 1 to 5 cc per minute. When using constant pressure perfusion in systems with partial distal ureteral obstruction, low or no flow is appreciated across the obstruction at renal pelvic pressures of 7 to 12 cm. water. By constant flow obstruction is defined in the same systems but only after renal pelvic pressures exceed 15 to 20 cm. water. We believe that there is clear clinical applicability.
为了确定一种更符合生理的方法来检测上尿路梗阻，我们在犬类和猪类模型中研究了恒压灌注技术。与惠特克的恒流技术不同，恒压灌注与上尿路顺应性无关，在肾盂中使用低固定压力（7至12厘米水柱），并测量上尿路的流速。在犬类和猪类模型中，相对于恒流，恒压灌注显示出更高的灵敏度，并且在正常和部分梗阻系统之间具有更好的区分能力。对于每分钟流入膀胱1至5毫升的流速，未梗阻的犬类和猪类肾盂压力通常较低（小于8厘米水柱）。在部分输尿管远端梗阻的系统中使用恒压灌注时，在肾盂压力为7至12厘米水柱时，梗阻处的流速较低或无流速。在相同系统中，通过恒流定义梗阻时，只有在肾盂压力超过15至20厘米水柱后才会出现。我们认为其具有明确的临床适用性。
