[利用肾盂测压法、x线及电视尿路镜确定肾造口闭合时间]。

Sovetskaia meditsina Pub Date : 1991-01-01
Iu A Pytel', L D Kadagidze
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引用次数: 0

摘要

为客观评价肾造口患者术后尿动力学恢复程度,确定最佳拔除肾造口引流管时间,我们进行了++视频尿动力学研究。包括顺行x线电视++肾盂输尿管镜++ +经瘘肾盂测深术。为了测量腹膜后压力对尿动力学的影响程度,还评估了腹膜内压力。造影造影剂灌注的容积率为1 ~ 7ml /min。术后不同时间对108例肾造口患者进行了检查。如果盆腔压力与腹腔压力之差不超过12 cm H2O,灌注容积率不同,则认为尿动力学恢复。108例患者中有76例(70.4%)确定上尿路有足够的尿液通过,可以尝试肾造口术。在32/108例(29.6%)患者中,研究结果不满意,需要通过肾造口引流管继续引流盆腔-肾盏系统。5-10天后复查尿动力学特征恢复正常。拔除肾造口引流管后无并发症发生。
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[Use of pyelomanometry and roentgenological and television uroscopy in determining the time for nephrostomy closing].

To evaluate objectively the degree of the urodynamics recovery in patients with nephrostomy in the postoperative period and to determine the optimal times of removing the nephrostomy drainage tubes, a ++video-urodynamic study was carried out. It consisted in combined antegrade X-ray TV ++pyelo-ureteroscopy and ++trans-fistula pyelomanometry. To measure the degree of the effect of retroperitoneal pressure on urodynamics, intraperitoneal pressure was also evaluated. The volumetric rate of the perfusion of the radiographic contrast substance ranged from 1 to 7 ml/min. As many as 108 patients with nephrostomy were examined within different times after the operation. Urodynamics was regarded as recovered, if the difference between pelvic and intraperitoneal pressure did not exceed 12 cm H2O, with the volumetric rate of perfusion being different. In 76/108 patients (70.4%), adequate passage of urine in the ++upper urinary tract was determined, which allowed one to attempt nephrostomy closing. In 32/108 patients (29.6%), the results of the study were viewed as unsatisfactory which required continuation of the draining of the pelvi-calyceal system by the nephrostomic drainage tubes. Repeated investigation carried out after 5-10 days revealed the normalization of the urodynamic characteristics. No complications were recorded after the nephrostomic drainage tubes were removed.

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