CAJ | 학술논문

目的通过对微通道经皮肾镜取石术(mPNL)手术前后血流动力学、血生化和相关激素的监测,探讨mPNL术中灌注液吸收对机体的影响.方法 2007年1月至2008年2月对128例肾结石或输尿管上段结石患者实施了mPNL.手术前后监测血红蛋白、红细胞压积、血浆渗透压、血电解质、血肌酐及肾素、血管紧张素Ⅱ和醛固酮.术中每30 min动态记录心率、平均动脉压和外周血氧饱和度的变化.结果术中患者的心率随着灌注时间延长而加快.术毕血浆渗透压、血清Cl-、肾素和血肌酐较术前增高.术毕血红蛋白、红细胞压积、血清K+较术前降低.平均动脉压、外周血氧饱和度、血清Na+、醛固酮和血管紧张素Ⅱ手术前后无明显变化.所有患者无严重并发症发生.结论 mPNL术中液体吸收的量与灌注时间呈正相关.一定量的液体吸收可引起患者血流动力学、血生化及血肾素的变化.
목적 통과대미통도경피신경취석술(mPNL)수술전후혈류동역학、혈생화화상관격소적감측,탐토mPNL술중관주액흡수대궤체적영향.방법 2007년1월지2008년2월대128례신결석혹수뇨관상단결석환자실시료mPNL.수술전후감측혈홍단백、홍세포압적、혈장삼투압、혈전해질、혈기항급신소、혈관긴장소Ⅱ화철고동.술중매30 min동태기록심솔、평균동맥압화외주혈양포화도적변화.결과 술중환자적심솔수착관주시간연장이가쾌.술필혈장삼투압、혈청Cl-、신소화혈기항교술전증고.술필혈홍단백、홍세포압적、혈청K+교술전강저.평균동맥압、외주혈양포화도、혈청Na+、철고동화혈관긴장소Ⅱ수술전후무명현변화.소유환자무엄중병발증발생.결론 mPNL술중액체흡수적량여관주시간정정상관.일정량적액체흡수가인기환자혈류동역학、혈생화급혈신소적변화.
Objective To determine the effects of irrigation fluid absorption on system hemodynamics,fluid-electrolyte and hormone during mini-percutaneous nephrolithotomy.Methods In this study 128 patients with renal calculus or calculus of superior ureter from January 2007 to February 2008 were collected.Hemoglobin (Hb),hematocrit (Hct),plasma osmotic pressure(POP),fluid-electrolyte,serum creatinine (Cre),renin,angiotensin Ⅱ and aldosterone were determined before and after operation.Heart rate (HR) ,mean arterial blood pressure (MAP) and oxygen saturation( SPO2) were recorded dynamically every 30 min.Results The HR speeded up accompanied with the irrigation time.When compared with before operation,POP,Cl-,renin and Cre were significantly increased after operation;Hb,Hct and K+were significantly decreased after operation;MAP,SPO2,Na+,aldosterone and angiotensin Ⅱ did not change significantly after operation.No serious surgery-related complication occurred in all patients.Conclusions Irrigation fluid is absorbed during mini-percutancous nephrolithotomy.The absorption amount is positively correlated with irrigation time.Changes of hemedynamics,fluid-electrolyte balance and renin may be caused by the irrigation fluid absorption.