Fung L C, Khoury A E, McLorie G A, Chait P G, Churchill B M
Department of Surgery (Division of Urology), Hospital for Sick Children, Toronto, Ontario, Canada.
J Urol. 1996 Mar;155(3):1045-9. doi: 10.1016/s0022-5347(01)66387-0.
We examined the pressure dynamics of hydronephrotic kidneys after elevated renal pelvic pressure developed.
A total of 40 patients (44 renal units) 0.2 to 12 years old was evaluated. Transiently elevated renal pelvic pressure was induced with a percutaneous nephrostomy infusion. After renal pelvic pressure increased the infusion was stopped and the subsequent decrease in pressure with time was plotted as a pressure decay curve. The rapidity of the decrease in renal pelvic pressure was then quantitated as a half-life for each pressure decay curve. Pressure decay half-lives were compared to corresponding pressure flow study results and diuretic nuclear renography half-lives.
Renal units without elevated renal pelvic pressure during infusion at a high physiological flow rate were associated with relatively rapid pressure decay, whereas those with elevated renal pelvic pressure during infusion were associated with much slower pressure decay (p < 0.0001). Diuretic nuclear renography half-lives had no correlation with collecting system pressure dynamics.
Pressure decay half-life provides an objective quantitative measure of the relative tendency for elevated renal pelvic pressure to persist. When used in conjunction with other diagnostic modalities, it may be a useful parameter for a comprehensive assessment of the risk of pressure induced injury in hydronephrotic kidneys.
我们研究了肾盂压力升高后肾积水肾脏的压力动态变化。
共评估了40例年龄在0.2至12岁的患者（44个肾单位）。通过经皮肾造瘘灌注诱导肾盂压力短暂升高。肾盂压力升高后停止灌注，并将随后压力随时间的下降绘制为压力衰减曲线。然后将肾盂压力下降的速度量化为每条压力衰减曲线的半衰期。将压力衰减半衰期与相应的压力流研究结果和利尿核素肾图半衰期进行比较。
在高生理流速灌注期间肾盂压力未升高的肾单位与相对较快的压力衰减相关，而在灌注期间肾盂压力升高的肾单位与慢得多的压力衰减相关（p < 0.0001）。利尿核素肾图半衰期与集合系统压力动态变化无关。
压力衰减半衰期提供了肾盂压力升高持续相对趋势的客观定量测量。当与其他诊断方法结合使用时，它可能是全面评估肾积水肾脏压力性损伤风险的有用参数。
