Nieh P T, Wurzel R S
Urology. 1985 Aug;26(2):129-34. doi: 10.1016/0090-4295(85)90044-5.
The use of intravenous 1/6 molar sodium lactate for dissolution of uric acid calculi is reported in 4 patients. All presented with a urine pH of 5. The calculi were located in the proximal ureter in 2 patients and in the renal pelvis in the other 2 patients. After infusion of 1/6 molar lactate, rapid alkalinization of the urine to pH 8 was achieved and maintained. The mean time required for dissolution of the calculi was 6.2 days precluding the need for surgical intervention. The mechanism of action of lactate is oxidative conversion to bicarbonate, providing a sustained alkaline urine. While our patients experienced no metabolic complications, one should monitor serum electrolytes, blood pressure, and fluid balance, particularly in cardiac-compromised patients.
据报道，4例患者使用静脉注射1/6摩尔乳酸钠溶解尿酸结石。所有患者尿液pH值均为5。2例患者结石位于输尿管近端，另外2例患者结石位于肾盂。输注1/6摩尔乳酸后，尿液迅速碱化至pH值8并维持该水平。结石溶解所需的平均时间为6.2天，无需手术干预。乳酸的作用机制是氧化转化为碳酸氢盐，从而提供持续的碱性尿液。虽然我们的患者没有出现代谢并发症，但应监测血清电解质、血压和液体平衡，尤其是心脏功能不全的患者。
