ObjectiveTo evaluate the relationship between renal pelvis pressure and infection after ureteroscopy, using a live swine model.Materials and MethodsIn anaesthetised pigs, a 1‐h ureteroscopy was performed using a pressure‐sensing guidewire, with renal pelvis pressure maintained at either 37 mmHg or 75 mmHg for the entire procedure and infusion with saline alone or with a standardised concentration of uropathogenic Escherichia coli strain CFT073 (1.5 × 107 colony‐forming units [CFU]/mL). Venous blood sampling was performed during and after the procedure. Vital signs, inflammatory biomarkers, and renal tissue and blood cultures were assessed.ResultsIn 21 pig kidneys, study groups were: 37 mmHg with saline irrigation (n = 3); 75 mmHg with saline irrigation (n = 4); 37 mmHg with saline irrigation with 1.5 × 107 CFU/mL E. coli (n = 7); and 75 mmHg with saline irrigation with 1.5 × 107 CFU/mL E. coli (n = 7). Statistically significant changes in inflammatory biomarkers were most pronounced in the group with 75 mmHg saline irrigation + E. coli and were significantly elevated compared with the control group and the group receiving E. coli irrigation at 37 mmHg. Positive blood cultures were noted in 5/7 animals treated with E. coli at 75 mmHg; no others developed bacteraemia.ConclusionIn this swine model of ureteroscopy, irrigation with saline + E. coli at a renal pelvis pressure of 75 mmHg resulted in bacteraemia and inflammatory biomarker elevations significantly greater than both E. coli irrigation with renal pelvis pressure maintained at 37 mmHg and the control.

中文翻译：

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活猪模型中肾盂压力与输尿管镜后感染的关系


目的采用活猪模型，评价输尿管镜术后肾盂压与感染的关系。材料和方法在麻醉猪中，使用压力感应导丝进行 1 小时输尿管镜检查，在整个过程中肾盂压保持在 37 mmHg 或 75 mmHg，并单独输注生理盐水或标准化浓度的尿路致病性大肠杆菌菌株 CFT073 （1.5 × 107 菌落形成单位 [CFU]/mL）。在手术期间和手术后进行静脉血采样。评估生命体征、炎症生物标志物以及肾组织和血培养。结果在 21 头猪肾脏中，研究组为： 盐水冲洗 37 mmHg （n = 3）;75 mmHg 盐水冲洗 （n = 4）;37 mmHg，用 1.5 × 107 CFU/mL 大肠杆菌进行盐水冲洗 （n = 7）;和 75 mmHg 用 1.5 × 107 CFU/mL 大肠杆菌进行盐水冲洗 （n = 7）。炎症生物标志物的统计学显着变化在 75 mmHg 盐水冲洗 + 大肠杆菌组中最为明显，并且与对照组和接受 37 mmHg 大肠杆菌冲洗组相比显著升高。在 5/7 只用 75 mmHg 大肠杆菌治疗的动物中观察到阳性血培养;没有其他人出现菌血症。结论在该猪输尿管镜模型中，肾盂压力为 75 mmHg 的生理盐水 + 大肠埃希菌冲洗导致菌血症和炎症生物标志物升高，显著高于肾盂压力维持在 37 mmHg 的大肠埃希叶灌溉和对照组。