摘要
目的探讨输尿管内置双J管后对上尿路动力学的影响。方法选取40例行经皮肾穿刺取石术患者,于术中输尿管内留置F4.8双J管,并留置F16肾造瘘管,术后1周内行上尿路动力学检查。结果肾盂压力的基础值与腹内压呈正相关,肾盂压力随腹内压升高而升高。留置F4.8DJ管后,行肾盂恒流灌注(10mL/min)时,肾盂压力无变化。留置F4.8DJ管后,行膀胱恒流灌注(40mL/min)时,储尿期肾盂压力呈现轻度升高,排尿期测定肾盂压力随膀胱压力升高而显著升高。结论留置支架管后,储尿期可造成肾内反流,患者肾盂压力轻度升高;排尿期肾盂压力明显升高,可能造成肾逆行感染和肾功能损害。我们应避免不必要的置管,同时内置双J管的留置时间应尽量缩短。
Objective To explore the effects of ＂double J＂ on upper urinary tract urodynamics.Method 40 cases patients in the hang who have a F4.8 double J in their ureter and a F16 nephrostomy tube in their Renal pelvic after percutaneous nephrolithotomy.Upper urinary tract urodynamics was performed between a week.Results Intraabdominal pressure related to the baseline of renal pelvic pressure,Renal pelvic pressure increased with Intraabdominal pressure.when set F4.8double J,renal pelvic pressure there was no change with 10mL/min intrapelvic perfusion;Renal pelvic pressure increased during the filling phases and increased evidently during the voiding phases when perfuse intravesical with 40ml/min.Conclusions As set double J,the stream of urine return renal pelvic,and renal pelvic pressure increased with the pressure of bladder during the filling phases and voiding phases.these instances will lead to renal infection and damage to renal function.so we should removed the tube as soon as early.
出处
《中国医药指南》
2010年第25期24-26,共3页
Guide of China Medicine
关键词
双J管
上尿路动力学
膀胱压力
肾盂压力
Double J
Upper urinary tract urodynamics
Blaader pressure
Renal pelvic pressure
