| Objective:To observe the intrapelvic pressure of patients with urethral stent (D-J stent) in bladder vacancy period,bladder filling period and bladder urination period when patients lying then sitting,and compare to the patients who don't have the D-J stent,in order to know the influence of the D-J stent to the intrapelvic pressure,and to discuss the time to leave the D-J stent in patients.Methods:The study group concludes 30 patients,after PCNL with D-J stent. All the patients are diagnosed as kidney calculi by urine routine,KUB and B-Ultrasound.The control group concludes 8 patients who did the surgery of puncture of kidney but no D-J stent.All the patients lied after micturition,and use the analyzer of urodynamics to measure bladder pressure,then use the tube which was measured cerebrospinal fluid to connect with kidney puncturing tube.Record the pressure of the vacancy bladder and intrapelvic pressure.Fill the bladder with water and record the pressure of filling bladder and intrapelvic pressure.Ask the patients to urinate and continue recoding the bladder pressure and intrapelvic pressure.Finally ask patients to sit and do the test again.Statistic and compare the data of two groups.Results:A total of 38 cases of patients with data analysis,of which 30 cases of study group,8 cases of the control group.①Study Group in Phase empty bladder pelvis pressure is 7.62±5.78 cmH2O,in bladder filling phase,the renal pelvis pressure is 24.8±6.80 cmH2O,in voiding period pelvis pressure reached 41.6±8.93 cmH2O,both have significant difference compared to(p＜0.01).②Control Group in Phase empty bladder pelvis pressure is 6.12±4.28cmH2O,in bladder filling phase,the renal pelvis pressure is 22.1±7.12cmH2O,in voiding period pelvis pressure reached 30.2±7.42cmH2O,both have significant difference compared to(p＜0.01).③line determination of the renal pelvis pressure,the non-voiding study group and control group without symptoms of bladder discomfort symptoms and back waist.Voiding process in research group,23.3%(7 / 30) of patients affected with varying degrees of low back pain symptoms.Control group of patients without back pain symptoms.Study Group 63.3%(19/30) of patients with voiding can be observed that the cerebrospinal fluid fistula is blue, including all the back pain patients.There were no patients in control group that the cerebrospinal fluid fistula turn blue.④Study Group in Phase pelvis voiding pressure is 41.6±8.93 cmH2O,the control group in voiding phase is 30.2±7.42 cmH2O.The two groups were significantly different(p＜0.01).⑤Study Group when urination,the bladder pressure increased,accompanied by the pressure on the renal pelvis increased markedly.The pressure of the renal pelvis and bladder pressure was significant correlation(p＜0.01).Conclusions:1 Through the urodynamics in patients with D-J stent in bladder empty period,filling period,and voiding period to observe the renal pelvis pressure,we found that in the voiding pressure the renal pelvis pressure was significantly increased which shows marked reflux voiding period.2 D-J stent in patients with renal pelvis pressure in the voiding phase was significantly higher than that in patients without D-J stent, which shows in the voiding of urine reflux is more obvious.3 The renal pelvis pressure and bladder pressure were significantly correlated in micturition,the higher the pressure bladder,the higher renal pelvis pressure.So after MPCNL kidney fistula should maintain open and maintain low pressure within the renal pelvis.4 The pressure in the voiding phase is significantly increased in the D-J patients.It can increase the renal pelvis repeatedly high pressure that can cause renal dysfunction.Therefore,after treatment it is as soon as possible to extract the stent. |
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