Perkütan nefrolitotripside yıkama sıvı volüm ve süresinin sıvı elektrolit dengesi ve hemodinamiye etkisi
Küçük Resim Yok
Tarih
2003
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Öz: Bu çalışma, perkütan nefrolitotripside (PNL) yıkama sıvısı olarak % 0.9 NaCI kullanıldığında, yıkama sıvı volümü ve süresi ile ilişkili olarak meydana gelen sıvı-elektrolit dengesi ve hemodinamik değişiklikler ile ortaya çıkan komplikasyonları saptamak amacıyla yapıldı. Çalışmaya alınan 22 olguya ait ortalama arter basıncı (OAB), kalp atım hızı (KAH), santral ven basıncı (SVB), Na+, K+, osmolalite (Osm), hemoglobin (Hb), hematokrit (Hct) değerleri yıkama öncesi, sırası ve sonrasında 10 dk aralarla, kreatinin (Cre), kan üre azotu (BUN) değerlerine ise yıkama öncesi ve sonrası bakıldı. Ayrıca cerrahi, yıkama süresi, yıkama sıvı volümü ve komplikasyonlar kaydedildi. Ortalama cerrahi süre 125.45 dk yıkama volümü 24.22 L yıkama süresi 69.40 dk olarak saptandı. OAB, KAH, SVB, Na+, K+, Osm yıkama sırası ve sonrasında yıkama öncesine göre anlamlı olarak değişmedi. Yıkama sıvı volümü ile yıkama sonrasındaki Na+ ve SVB değeri arasında pozitif yönde zayıf-orta derecede, yıkama sırasındaki SVB değeri arasında ise pozitif yönde anlamlı ilişki saptandı. Yıkama süresi ile sadece yıkama sonrası Na+ değeri arasında anlamlı pozitif ilişki saptandı. İşlem sırasında pnömotoraks meydana gelen bir olgu toraks tüpü takılarak tedavi edildi. Sonuç olarak; PNL'de yıkama sıvısı olarak % 0.9 NaCI kullanıldığında, hem sıvı elektrolit dengesi hem de hemodinaminin, yıkama sıvı volümü ve süresinden klinik olarak anlamlı etkilenmediği ancak yüksek yıkama sıvı volümü kullanılması ve uzun süre yıkama yapılmasında OAB, SVB, Na+ ve Osm değerlerinin yakın takibi gerektiği kanısındayız.
Abstract: This study was performed to determine fluid-electrolyte and hemodynamics changes and complications associated with irrigation fluid volume and irrigation time in percutaneous nephrolithotripsy (PNL) in which 0.9 % NaCI was used. Mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), Na+, K+, osmolality (Osm), haemoglobin, haematocrit values of 22 cases that were included into the study were recorded before, during and after irrigation every 10 minutes. Creatinine (Cre), blood urea nitrogen (BUN) were determined before and after irrigation. Moreover, operation and irrigation time, irrigation fluid volume, and complications were recorded. Mean time of operation and irrigation, irrigation fluid volume were determined 125.45 min, 69.40 min, 24.22 L, respectively. MAP, HR, CVP, Na+, K+, Osm did not significantly change during and after irrigation when compared to before irrigation. Fair degree of positive relationship was determined between irrigation fluid volume and Na+, CVP values after irrigation. Also significant positive relationship was determined between irrigation fluid volume and CVP during irrigation. Only significant positive relationship was determined between irrigation time and Na+ after irrigation. One case who developed pneumothorax developed during procedure was treated by inserting a thoracal tube. As a result, we established that there were no clinically significant changes in both fluid-electrolyte balance and hemodynamics related to irrigation fluid volume and irrigation time when 0.9 % NaCI was used in PNL. However we suggested that MAP, CVP, Na+ and Osm should be monitored closely when extensive amount of irrigation fluid volume and irrigation time were used.
Abstract: This study was performed to determine fluid-electrolyte and hemodynamics changes and complications associated with irrigation fluid volume and irrigation time in percutaneous nephrolithotripsy (PNL) in which 0.9 % NaCI was used. Mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), Na+, K+, osmolality (Osm), haemoglobin, haematocrit values of 22 cases that were included into the study were recorded before, during and after irrigation every 10 minutes. Creatinine (Cre), blood urea nitrogen (BUN) were determined before and after irrigation. Moreover, operation and irrigation time, irrigation fluid volume, and complications were recorded. Mean time of operation and irrigation, irrigation fluid volume were determined 125.45 min, 69.40 min, 24.22 L, respectively. MAP, HR, CVP, Na+, K+, Osm did not significantly change during and after irrigation when compared to before irrigation. Fair degree of positive relationship was determined between irrigation fluid volume and Na+, CVP values after irrigation. Also significant positive relationship was determined between irrigation fluid volume and CVP during irrigation. Only significant positive relationship was determined between irrigation time and Na+ after irrigation. One case who developed pneumothorax developed during procedure was treated by inserting a thoracal tube. As a result, we established that there were no clinically significant changes in both fluid-electrolyte balance and hemodynamics related to irrigation fluid volume and irrigation time when 0.9 % NaCI was used in PNL. However we suggested that MAP, CVP, Na+ and Osm should be monitored closely when extensive amount of irrigation fluid volume and irrigation time were used.
Açıklama
Anahtar Kelimeler
Kaynak
Türk Anestezi ve Reanimasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
31
Sayı
4
Künye
KÖROĞLU A,TOĞAL T,ÇİÇEK M,KILIÇ S,AYAS A,ERSOY M. Ö (2003). Perkütan nefrolitotripside yıkama sıvı volüm ve süresinin sıvı elektrolit dengesi ve hemodinamiye etkisi. Türk Anestezi ve Reanimasyon Dergisi, 31(4), 174 - 178.
