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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 investigate the effects of ureteral double J tube on the dynamics of upper urinary tract. Methods Forty patients undergoing percutaneous nephrolithotomy were enrolled in this study. F4.8 double J tube was placed in the ureter during operation and F16 nephrostomy tube was placed. The upper urinary tract mechanical examination was performed within 1 week after operation. Results The basic value of renal pelvis pressure was positively correlated with intra-abdominal pressure. The pelvis pressure increased with the increase of intra-abdominal pressure. After indwelling F4.8DJ tube, renal pelvis pressure constant (10mL / min), no change in renal pelvis pressure. After indwelling F4.8DJ tube, urinary pelvic pressure increased slightly when bladder constant infusion (40mL / min) was performed. Urine pelvic pressure increased significantly with the increase of bladder pressure during urination. Conclusion After indwelling stent tube, the urine storage period can cause intrarenal regurgitation, and the pelvic pressure of patients slightly increases. The urinary pelvic pressure increases obviously, which may lead to retrograde renal infection and renal dysfunction. We should avoid unnecessary catheterization, while the built-in double J tube retention time should be shortened.