Characters and significance of renal pelvic pressure in minimally invasive ureteroscopic lithotripsy for urethral calculis
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摘要: 目的：探讨输尿管镜碎石术术中肾盂压力的变化对术后发热的影响。方法：采用压力传感器实时测量124例行输尿管镜碎石术的患者肾盂内压力，分析肾盂内压力的变化与术后发热的关系。结果：124例患者术中平均肾盂内压2.07 kPa（1 kPa=7.5 mm Hg），肾盂内压力 ≥ 4.00 kPa平均累计时间为96.72 s。术后有30例（24.2%）患者发热。术后发热与患者年龄（P=0.243）、性别（P=0.135）、尿路感染（P=0.183）、术后血常规白细胞 ≥ 10×109/L（P=0.317）、术中肾盂内压力曾经 ≥ 5.33 kPa （P=0.260）无明显关系。而与感染性结石（P=0.002）、术中平均肾盂内压力 ≥ 2.67 kPa （P=0.017）、肾盂内压力 ≥ 4.00 kPa持续时间（P=0.011）相关。结论：术后发热与输尿管镜碎石术导致的肾盂内压力短暂性增高不相关，但术中平均肾盂内压力、肾盂内压力 ≥ 4.00 kPa持续时间升高将引起术后发热率增高。Abstract: Objective: To investigate the renal pelvic pressure (RPP) during minimally invasive ureteroscopic lithotripsy for urethral calculi, and inspect its influence to postoperative fever. Method: The RPP was measured by barometer. And these data about pressure and postoperative fever were evaluated statically. Result: The mean RPP was 2.07 kPa, the mean accumulative time of RPP ≥ 4.00 kPa was 96.72 s. 30 cases (24.2%) had a postoperative fever. Logistic analysis suggested that postoperative fever did not correlate to age(P=0.243), sex(P=0.135), urinary tract infection (P=0.183), white blood cell ≥ 10×109/L in blood routine examination postoperatively (P=0.317), once an occurrence of RPP ≥ 5.33 kPa (P=0.260), while infection calculi(P=0.002), mean RPP ≥ 2.67 kPa (P=0.017), and RPP ≥ 4.00 kPa longer than 60s(P=0.011) contributed to postoperative fever. Conclusion: A transient RPP ≥ 30 mm Hg don't contribute to postoperative fever, while a temporary high pressure(60s) would had an accumulated effect which means an enough back flow to bring a fever.
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Key words:
- renal pelvic pressure /
- urethral calculi /
- lithotripsy /
- fever
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