输尿管镜碎石术中测压评估上尿路梗阻程度的初步应用

目的介绍一种输尿管镜碎石术中测量输尿管腔内压的方法，并评价其临床应用价值。方法以44例输尿管上段结石患者为研究组，其中急性梗阻21例，慢性梗阻23例；以22例无结石梗阻但需行输尿管镜检的患者为对照组。碎石术中置输尿管镜于结石上方输尿管段，关闭灌注液，镜尾部连接延长管至压力换能器，结石上方输尿管腔内的液体压力即可转换为数字压力值。对压力值与梗阻时间、结石上方输尿管长径、肾盂积水深度、血肌酐浓度、每微升尿白细胞数等作相关分析。结果急性、慢性梗阻亚组及对照组输尿管腔内压分别为74．5mmHg（22～1801、32．5mmHg（9～53）、10．2mmHg（8—13）（1mmHg=0．133kPa）。研究组输尿管压力值与梗阻时间（r=0．985）、结石上方输尿管径（r=0．878）、肾盂积水深度（r=0．862）有明显相关关系，与血肌酐（r=0．214）、尿自细胞数（r=0．047）无明显相关关系。慢性梗阻亚组的输尿管压力值与患侧肾小球滤过率有明显的相关性（r--0．975）。结论本法简便无创伤性，可实时、量化测定输尿管腔内压力，对评估输尿管结石造成的上尿路梗阻程度有一定的应用价值。

Initial experience of applicating an easy method to monitor the intraluminal pressure of the ureter during ureterscopic lithotripsy

Objective To introduce a new method to monitor the intraluminal pressure of the ureter and evaluate its clinical significance.Methods Totally 44 cases of proximal ureteral calculi were enrolled in the study group,21 cases of them had acute obstruction,and the other 23 cases hadchronic obstruction.22 cases without any calculi but needed ureteroscopy examination were enrolled as the control group.Duringthe procedure of lithotripsy,placed the ureterscopy above the obstruction segment immediately after the ston...