Ultrasound-guided renal cyst puncture and 95% ethanol injection. Part 1: Estimation of ethanol levels in the blood and urine following 95% ethanol injection
| Autor: | KAWAMURA, Juichi, HIURA, Masaru, UEDA, Makoto, HIGASHI, Yoshihito, YOSHIDA, Osamu, KUWAHARA, Chiemi, UEDA, Masao |
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| Jazyk: | japonština |
| Rok vydání: | 1984 |
| Předmět: | |
| Zdroj: | 泌尿器科紀要. 30(3):287-294 |
| ISSN: | 0018-1994 |
| Popis: | 孤立性腎嚢胞16例17嚢胞に対し, 超音波ガイドによる経皮的嚢胞穿刺をおこない, 嚢胞壁の凝固物質とし95%エタノールを嚢胞液量の26～91%(平均62%)注入し, 20分留置回収した.この操作にともなう生体内でのエタノールの動きを血中と尿中エタノール・レベルより観察した.エタノール回収率は59～97%(平均82.4%)であった.1)血中エタノール濃度はほぼ30～60分後に最高値に達し, 0.015～0.339 mg/mlに分布した.尿中排泄量は60～120分までに最高となった.2)投与エタノール量と血中最高濃度(r=0.66)や12時間尿中排泄量間には正の相関関係をみた.3)体内残留エタノール量に比べ12時間尿中排泄量は少なかった(平均2.3%), 尿中/血中エタノール比はきわめて高く, 嚢胞壁から吸収して全身血行動態へ移行するものより, 腎から直接に尿中へ排泄するものの方が多かった.4)以上から, 嚢胞内への95%エタノール注入は一過性に血中エタノール濃度と尿中排泄を増加するが, エタノールの回収を確実におこなえば, 生体に影響することなく, 安全に施行できると考えた Seventeen solitary renal cysts were punctured with the ultrasound-guided procedure and 26-91% of the cyst volume was replaced with 95% ethanol used as a sclerosing agent of the cyst wall. Ethanol was injected through a 7 F pigtail ureteral catheter, allowed to remain in place for 20 minutes and removed through the catheter. Recovery rate of ethanol was 82.4%. The maximum blood level of ethanol was obtained 30 to 60 minutes after injection, while the maximum urinary excretion rate was observed after 60 to 120 minutes. The maximum blood levels of ethanol ranged from 0.015 to 0.339 mg/ml. There was a positive correlation between injected volume of ethanol and the maximum blood level (r = 0.66) or the total amount of urinary excretion during 12 hours (r = 0.72). Residual ethanol concentrations in the body were calculated from injected volume and recovery rate of ethanol. Only 2.3% of the residual ethanol in the body was excreted in the urine during the first 12 hours after injection. However, urine/blood ratio of ethanol 1 hour after injection was tremendously high with a wide variation between 1.6 and 230.5. Therefore, a large part of the ethanol absorbed from the cyst wall seems to be excreted directly from the kidney, not entering general circulation. From the estimation of the blood and urine levels of ethanol, it is concluded that 95% ethanol can be applied to the renal cyst wall as a sclerosing agent through the percutaneous ultrasound-guided procedure in the case of good recovery of ethanol. |
| Databáze: | OpenAIRE |
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