摘要
目的:利用兔模型实验探索怎样利用肾周冰水联合肾盂逆行灌注冰水保护肾脏功能。方法:将60只新西兰大白兔完全随机分为四组,每组15只,A组为肾盂逆行灌注冰水组,B组为肾周冰水降温组,C组为肾周冰水联合肾盂逆行灌注冰水组,D组为空白对照组。肾动脉阻断后每隔1min分别记录各组肾表面和实质温度,阻断肾动脉1h及2h末分别取少量肾组织送病理学检查。比较各组肾组织病理学方面的差异,比较各组肾表面及肾实质的平均温度,绘制各组温度变化曲线,比较各组之间有何不同。结果:C组(联合降温组)的肾表面和肾实质平均温度明显低于其他各组(P<0.05)。C组降温最快,肾组织的病理学改变最轻。结论:肾周冰水联合肾盂逆行灌注冰水降低肾脏温度,效果确切,可为后腹腔镜保留肾单位手术中保护肾功能提供新的方法。但仍需进行更多的研究来证实其有效性。
Objective： The renal blood flow is usually blocked to reduce bleeding during laparoscopic partial nephrectomy. However blocking renal blood flow can result in hot ischemic injury of kidney. Kidney cryogenic technology can protect kidney function. In this study, an rabbit model was established to explore how to reduce kidney temperature and protect renal function more effectively by the perirenal ice water joint ureteral retrograde ice water .Methods： 60 New Zealand white rabbits were randomly divided into four groups and 15 rabbits were in each group. Cold saline was injected into pelvis through ureter catheter in Group A. Ice water was injected into the interplace around renal in Group B. The perirenal ice water combined with ureteral retrograde ice water cooling method was used in Group C. Group D was blank control group. Both kidney surface temperature and kidney parenchyma temperature was recorded per minute after blocking the renal artery with a bulldog clamp. Tissue fragments were taken out from kidney by a biopsy needle at the end of 1 hour and 2 hours after blocking the renal artery. Pathological examination for the tissue fragments was carried out. Kidney surface and parenchyma temperature changes of three groups were compared and analyzed. A time-temperature diagram was designed. The difference between the groups was compared.Results： The average temperature of kidney surface and kidney parenchyma in group C （combined cooling group） was significantly lower than that in other groups （P〈0.05）. Group C had the fastest temperature drops and the lightest renal pathological changes. Conclusion： The cold ischemia technology by perirenal ice water combined with ureteral retrograde ice water can reduce the kidney temperature obviously and can protect kidney function more effectively, which may provide a new method to protect kidney function in Laparoseopic Partial Nephrectomy. However, more research is needed to confirm its effectiveness.
出处
《北方药学》
2015年第10期96-98,共3页
Journal of North Pharmacy
关键词
保留肾单位手术
低温
保护肾功能
肾癌
Nephron sparing operation
Low temperature
Protection of renal function
Renal carcinoma
