title: [Effects of irrigating fluid absorption in percutaneous nephrolithotripsy].
abstract: OBJECTIVE
  To determine the hemodynamic status, fluid-electrolyte changes and complications associated with irrigation time in percutaneous nephrolithotripsy.
  
  
  METHODS
  A total of 68 renal calculi patients (31 males and 37 females) were recruited. The lateral recumbent percutaneous nephrolithotripsy was operated with Ho laser under ultrasonic guidance. 0.9% NaCI was used as perfusion fluid. The following items were recorded: mean arterial blood pressure (MAP), heart rate, central venous pressure (CVP), hemoglobin, sodium, potassium and chloride; perfusion time during operation; peri-operative and post-operative complications.
  
  
  RESULTS
  (1) Peri-operative and post-operative conditions: the average operative time was 83.1 +/- 22.21 minutes. Two cases stopped because of bleeding after puncture and the tube of stoma was placed for stone clearance of the second time. There was more bleeding in 11 patients, but the operations were continued with blood transfusion and close monitoring. Two operations ceased because of a premunition of congestive heart failure. Nine patients needed post-operative blood transfusion and 18 had a post-operative fever. One patient bled in and around the tube and had a peri-renal infection a week later. (2) Changes of observation parameters: there was no significant difference in CVP, heart rate, hemoglobin, sodium, potassium and chloride (P > 0.05). The post-perfusion value of MAP increased (P < 0.05) especially in the cases of more bleeding and long time of irrigation. Peri-operative and post-operative injection of furosemide could reduce the CVP value. The average irrigation time in the fever group was longer than the non-fever group (P < 0.05) and the CVP value of the fever group was higher than the non-fever group (P < 0.05).
  
  
  CONCLUSIONS
  Low pressure and short time of perfusion are safe in clinical practice. Congestive heart failure after the perfusion and the occurrence of post-operative infections are difficult to avoid when there are a long time of irrigation and more bleeding during operation.
authors.affiliation: Department of Urology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Ren
authors.forename: Shao-Bin
authors.initials: SB
authors.lastname: Ni
authors.forename: Qi-Yin
authors.initials: QY
authors.lastname: Chen
authors.forename: Chang-Lin
authors.initials: CL
authors.lastname: Wang
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Fu
authors.forename: Zhi-Xing
authors.initials: ZX
authors.lastname: Jiao
authors.forename: Li
authors.initials: L
authors.lastname: Ma
authors.forename: Zhong-Shan
authors.initials: ZS
authors.lastname: Zhao
authors.forename: Yong-Shun
authors.initials: YS
authors.lastname: Duan
mesh_terms: D000328:Adult; D000368:Aged; D002496:Central Venous Pressure; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D010477:Perfusion; D011183:Postoperative Complications