[Effects of irrigating fluid absorption in percutaneous nephrolithotripsy].
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.
Ren
Ming-Hua
MH
Department of Urology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
Ni
Shao-Bin
SB
Chen
Qi-Yin
QY
Wang
Chang-Lin
CL
Fu
Yi-Ming
YM
Jiao
Zhi-Xing
ZX
Ma
Li
L
Zhao
Zhong-Shan
ZS
Duan
Yong-Shun
YS
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