High-pressure Perfusion Of The Renal Pelvis And The Correlation Between Postoperative Blood Infection In Rabbit

Objective: To explore the correlation between high-pressure perfusion of the renal pelvis and postoperative bloodinfection in rabbit,and to ascertain the change of renal pathology during high-pressure perfusion of the renal pelvis.Methods : 56 New Zealand rabbit divided into experimental and control groups randomly. The experimental group contains constant perfusion time group and constant perfusion pressure group. The constant perfusion time group were divided into 3 groups witch called S1,S2,S2 respectively according to the perfusion pressure, the perfusion time of them are 5 minute, and the perfusion pressure are 48cmH2O(35.3mmHg),37cmH2O(27.2mmHg),28cmH2O(20.5 mmHg)respectively . The constant perfusion pressure group were divided into 2 groups witch called S4 and S5 respectively according to the perfusion time, the perfusion pressure of them are 37cmH2O(27.2mmHg),and the perfusion time are 10 minute and 1 minute respectively .The control group were divided into 2 groups witch called D1 and D2. The perfusion time and perfusion pressure of D1 group are 48cmH2O(35.3mmHg)and 10 minutes,and the perfusate of D1 group is stroke-physiological saline solution.The D2 group avoid pelvis perfusion. The perfusate of all the experimental groups are physiological saline solution witch contains E.coli. Monitoring of body temperature, respiration rate, heart rate; count the WBC of the blood;determine the CRP and TNF-αof the serum;and hemoculture preoperativily and postoperatively.Both the left and right kidneys send to do pathological examination.Results: (1) Temperature:The preoperative and postoperative temperature of group S1 are significant different(P<0.01),and those of the group S4 are significant different(P<0.01);The preoperative and postoperative temperature of the control groups and the rest experimental groups have no significant difference; Compare to the control groups and group S2 and group S3, the postoperative temperature of group S1 is significant different(P < 0.01); Compare to the control groups and group S2 and group S5, the postoperative temperature of group S4 is significant different(P<0.01). (2) WBC: The postoperative quantity of WBC in the blood witch compared to the preoperative one are significant different in both the control groups and experimental groups (P<0.01); Compare to the control groups and group S2 and group S3, the postoperative quantity of WBC in the blood of group S1 is significant different(P<0.01); Compare to the control groups and group S2 and group S5, the postoperative quantity of WBC in the blood of group S4 is significant different(P<0.01). (3) CRP: The postoperative CRP of the serum witch compared to the preoperative one are significant different in both the control groups and experimental groups (P<0.01); Compare to the control groups and group S2 and group S3, the postoperative CRP of the serum in group S1 is significant different(P<0.01); Compare to the control groups and group S2 and group S5, the postoperative CRP of the serum in group S4 is significant different(P<0.01). (4) TNF-α: The postoperative TNF-αof the serum witch compared to the preoperative one are significant different in both the control groups and experimental groups (P<0.01); Compare to the control groups and group S2 and group S3, the postoperative TNF-αof the serum in group S1 is significant different(P<0.01); Compare to the control groups and group S2 and group S5, the postoperative TNF-αof the serum in group S4 is significant different(P<0.01). (5) Hemoculture: The postoperative hemoculture of the control groups and group S3 and group S5 were negative;the positive cases of group S1,S2andS4 is 8(8/8),1(1/8)and7(7/8) respectively. The Positive rate of the postoperative hemoculture is related to the perfusion pressure,the correlation coefficient is 0.843,P<0.01; The Positive rate of the postoperative hemoculture is related to the perfusion time,the correlation coefficient is 0.786,P<0.01. (6) Pathology: The pathology of the left kidney in the control groups are normal. The pathology of the left kidney in the group S1 and S4 are mainly showed to be hyperphlogosis,while the group S2 mainly showed to be moderate inflammation,otherwise, the group S2 mainly showed to be mild inflammation. The pathology of the right kidney in all the groups are normal.Conclusions: (1)High-pressure perfusion of the renal pelvis can cause postoperative blood nonspecific infection,and the higher the pressure is ,the higher the infection rate is,otherwise, the longer the perfusion time is , the higher the infection rate is. (2) High-pressure perfusion of the renal pelvis can cause the pathology of the kidney showed to be acute inflammation, and the higher the pressure is ,the more severe the inflammation is,otherwise, the longer the perfusion time is , the more severe the inflammation is. (3) Pelvis reflux witch caused by high-pressure perfusion of renal pelvis may be one of the mechanisms of the postoperative blood infection of the patient whom undergo PCNL because of renal lithiasis.