恒温低压滴注与推灌在顺行上尿路造影中的比较

Comparison of the effects on the homothermal and low pressure drip and injection in the upper urography

目的比较恒温低压滴注上尿路造影与推灌上尿路造影的有效性及安全性。方法选取12例伴重度肾积水而行肾造瘘患儿,随机分为恒温低压滴注造影组(滴注组)和推灌造影组(推灌组)各6例。造影前2组患儿体温均正常,尿常规:白细胞数<5个/高倍视野(HP),细菌阴性,白细胞酯酶阴性;血常规正常。分别观察造影完成的时间、显象范围,造影后患儿体温,血常规,C反应蛋白(CRP),尿常规。结果 2种造影方法均能清晰显露尿路梗阻部位形态结构;恒温低压滴注造影显影速度较推灌法显影过程慢,但显影效果好,显影区域广,能更好的显露梗阻部位远端尿路形态。推灌组在术后第2 d发热5例,而滴注组只有1例发热,血常规、CRP和尿常规显示推灌法可引起体内感染体内感染。结论恒温低压滴注造影比推灌造影在安全性、有效性上更有优势。

Objective To compare the validity and safety in the homothermal and low pressure drip and the injection in the upper urography. Methods 12 children were selected from the patients who were carried out a nephrostomy for PUJO with severe hydronephrosis. They were randomly divided into two groups, the homothermal and low pressure drip group（ group A） and the injection group（ group B） ,6 cases in each group. The clinical data were normal before urog- raphy in these 12 cases. After urography, the finished time, the area of the development, the temperature of the next day, urinalysis and hemanalysis were proceeded. Results Two kinds of urography can clearly reveal the morphology of urinary tract obstruction. The developing of homothermal and low pressure drip was slower than that of the injection method urography, but the former showed effective developing, region wide developing, and can better reveal the shape of distal urinary tract obstruction. There were five cases of fever in group B and one case of fever in group A. Urinaly- sis and hemanalysis showed that more severe infection was appeared in group B. Conclusion s It showed much more validity and safety in the homothermal and low pressure drip than these showed in the injection in the upper urogra- phy.