Effects Of Irrigation Fluid's Absorption On System During Mini-Percutaneous Nephrolithotomy

[Objective]To determine the effects of irrigation fluid's absorption on system hemodynamics,fluid-electrolyte and hormone during mini-percutaneous nephrolithotomy.[Methods]In this study 128 patients with renal calculus or calculus of superior ureter from 2007/01 to 2008/02 were collected.They all underwent mini-percutaneous nephrolithotomy.0.9%NaCl was used as irrigant during operation.The speed of irrigation was less than 200ml·min^-1.Heart rate(HR),mean arterial blood pressure (MAP)and pulse oxygen saturation(SpO₂)were recorded before and after irrigation and during irrigation every 30min.Hemoglobin(Hb),hematocrit(Hct),plasma osmotic pressure(POP),Na⁺,K⁺,Cl^-,serum creatinine(Cre),blood urea nitrogen (BUN),renin,angiotensinâ…¡and aldosterone were determined before and after operation.[Results]All the operations were completed successfully.The mean irrigation time was 79.45±31.21min,and the mean irrigation fluid volume was 22.43±12.08L.No irrigation fluid absorption syndrome and other serious surgery-related complication occurred,did blood transfusion neigther.During irrigation HR speeded up accompanied with the irrigation time.HR was significantly different between every two stages.When compared with before operation,POP,Cl^-,renin and Cre were significantly increased after operation;Hb,Hct,K⁺ and BUN were significantly decreased after operation;MAP,SpO₂,Na⁺,aldosterone and angiotensinâ…¡did not change significantly after operation.[Conclusion]Irrigation fluid's absorption was observed during mini-percutaneous nephrolithotomy.No significant changes were found in hemodynamics, fluid-electrolyte balance and hormone for those patients with normal compensation of body fluid.But some complications might take place if extension of operation time, loss of tunnel,perforation of renal pelvis,renal parenchyma and ureter exist during mini-percutaneous nephrolithotomy.These complications might lead to irrigation fluid absorption syndrome.Therefore,the monitoring of hemodynamics, fluid-electrolyte balance and hormone,especially hemodynamics,was very important to discover irrigation fluid absorption syndrome in time.