Cariou G, Le Duc A, Serrie A, Cortesse A, Teillac P, Ziegler F
Ann Urol (Paris). 1985;19(2):83-6.
The publication of several accidents, possibly due to the reabsorption of irrigation solutions in the course of percutaneous nephrolithotomy, prompted the authors to quantify the amounts of glycine (1.50 per cent glycocol) reabsorbed in these operations, and to determine the metabolic consequences. In a prospective study of twelve patients subjected to fourteen percutaneous nephrolithotomies, the hemodilution parameters (natremia, protidemia, hematocrit and osmolality) and the amino acid content of the plasma were measured preoperatively, at operation, and immediately postoperatively. The study indicates that there is a hemodilution and reabsorption of irrigation solute comparable to that observed in transurethral resections of the prostate. The resultant hyperglycinemia probably explains the significant increase in ammonemia noted in all the patients. One theory is that hepatocellular insufficiency may increase this ammonemia. This might suggest the advisability of using saline solution, at least in these patients (that is, of course, in the absence of electrical lithotrity).
几起可能因经皮肾镜取石术中冲洗液重吸收导致的事故报道,促使作者对这些手术中重吸收的甘氨酸(1.50%氨基乙酸)量进行量化,并确定其代谢后果。在一项对12例患者进行14次经皮肾镜取石术的前瞻性研究中,术前、术中及术后即刻测量血液稀释参数(血钠、蛋白血症、血细胞比容和渗透压)及血浆氨基酸含量。研究表明,存在与经尿道前列腺切除术所见相当的冲洗溶质血液稀释和重吸收情况。由此产生的高甘氨酸血症可能解释了所有患者氨血症的显著增加。一种理论认为,肝细胞功能不全可能会加重这种氨血症。这可能提示至少在这些患者中(当然,在没有电碎石术的情况下)使用盐溶液的可取性。