摘要
目的探讨犬尿道直肠瘘动物模型建立的最佳手术方式。方法2016年6-10月选取15只健康雄性杂种犬。年龄2～3岁，平均2．5岁。体重12—15蝇，平均13．5kg。静脉麻醉后，随机抽取5只行经肛门直肠拖出冷刀切开建模，将中心静脉导丝用无菌石蜡油充分润滑后插入尿道起指示作用，两把组织钳在尿道膜部同时固定中心静脉导丝、尿道、直肠组织，用手术刀在两把组织钳间纵行切开约1．5cm的直肠尿道组织；再随机抽取5只犬行经腹会阴途径建模，同前尿道置入中心静脉导丝做为标志，分离尿道腹侧周围组织，先用手术刀在尿道膜部腹侧纵行切开，抽出中心静脉导丝，用两把组织钳固定、充分暴露尿道，然后纵行切开背侧尿道至直肠，长约1．5cm；余5只犬行经肛门直肠括约肌切开建模，逐层切开肛门括约肌各层，每层用4号丝线标记以便术后逐层缝合，同前尿道置入中心静脉导丝做为标志，在尿道膜部纵行切开长约1．5cm的尿道直肠组织。各组分别于术后1、2、3个月行逆行尿道膀胱造影检查，以及尿道内加压注入亚甲蓝观察直肠内白色纱布蓝染情况；分别于术后3个月行瘘口病理组织学检查评价建模效果。结果经肛门直肠拖出冷刀切开组：术后1、2、3个月逆行尿道直肠造影检查示瘘口存在，尿道内加压注入亚甲蓝可观察到直肠内白色纱布蓝染，病理组织学检查示组织黏膜固有层紊乱，存在大量炎症细胞，5只犬均建模成功。经腹会阴途径组：1只犬术后1周自行咬开缝线后死亡；1只犬术后1个月在肛门下方2cm处出现直径约3cm的窦道，有粪尿混合物流出，尿道口无尿液流出，建模失败；余3只犬术后1周手术刀口出现严重感染，出现严重的排尿困难，术后1、2、3个月逆行尿道直肠造影检查示瘘口存在，尿道内加压注入亚甲蓝可见直肠内白色纱布蓝染，建
Objective Objective To explore the best dog urethra rectum fistula operation method. Methods In June 2016 to October 2016,15 healthy male dogs were selected as research objects, aged 2-3 years （mean 2.5 years） , with a body mass of 12-15 kg （mean 13.5 kg）. They were randomly divided into three groups, each group of five. 5 male dogs were cut through the rectum. 5 male dogs were cut through the perineum. 5 male dogs were cut through the rectal sphincter of the anus. Postoperative retrograde urethrectomy rectum angiography, the urethral pressure injection of methylene blue white gauze aizen rectum fistula and histologic evaluation of each group were compared 1,2,3 moths after the operation. Results Anal rectum drag cold knife cut group, 1,2,3 moths after the operation, postoperative indicated the exist of orificium fistulae. The urethral pressure injection of methylene blue could observe rectum white gauze aizen,and pathological histology suggested the mucosal lamina propria disorder. There were a large number of inflammatory cells,5 dogs models were successfully built. Abdominal perineal pathway group： 1 dog was killed by itself. 1 dog one month after operation in anus at 2 cm below diameter about 3 cm appeared in a mixture of urine fistula and urethral orifice outflow, no urine outflow. More than 3 dogs after a week in the edge of serious infection, a canine model of severe dysuria, 1,2,3 moths after the operation, postoperative indicated the exist of orificium fistulae. The urethral pressure injection of methylene blue could observe rectum white gauze aizen. 3 dogs models were built. Through anal sphincter incision group：five dogs of the urethral fistula were successful, and one dog was incontinent with fecal incontinence. Conclusions The rectal rectum could successfully produce the animal model of the urethral rectal fistula and provide the experimental subjects for the treatment of iatrogenic urethral fistula.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2017年第11期870-874,共5页
Chinese Journal of Urology
基金
2015年河南省医学科技攻关计划指导性计划项目（201504012）
关键词
雄性杂种犬
尿道直肠瘘
动物模型
尿道直肠造影
Male mongrel dogs
Urinary rectal fistula
Animal model
Urethral rrectum rradiography
