摘要
目的:探讨模拟经皮肾镜碎石术中不同通道孔径对兔肾脏损伤的影响。方法:选取新西兰大白兔18只,根据术中通道孔径的不同分为巨大通道组,标准通道组和微通道组,每组各6只。术中全麻后,垫高腰背部充分暴露,在左侧肋缘下与腰骶肌交界处作一平行切口,长度约2 cm,逐层切开皮肤、肌肉,然后使用不同孔径的注射器针头刺入肾脏,深度为0.5 cm。使用纱布压迫止血,最后缝合筋膜和皮肤,结束手术。记录手术时间及肾脏出血量,术后第1天和第3天于兔耳缘静脉采血化验肾功能相关指标。术后1个月取兔肾脏标本进行病理检查,并计算瘢痕面积。结果:巨大通道组、标准通道组和微通道组的手术时间分别为(51.2±3.5)min、(55.1±4.7)min、(51.3±4.2)min,差异无统计学意义(P>0.05);肾脏出血量分别为(5.3±0.8)ml、(2.4±0.7)ml、(1.8±0.4)ml,差异有统计学意义(P<0.05);止血时间分别为(10.2±1.9)min、(8.1±1.4)min、(3.4±0.8)min,差异有统计学意义(P<0.05)。微通道组、标准通道组和巨大通道组术后1 d肌酐分别为(263.0±7.6)μmol/L、(282.0±8.5)μmol/L、(298.3±8.7)μmol/L,差异有统计学意义(P<0.05)。尿素氮分别为(19.0±2.8)mmol/L、(22.0±3.7)mmol/L、(24.3±4.2)mmol/L,差异有统计学意义(P<0.05)。术后3 d肌酐分别为(253.0±4.6)μmol/L、(262.0±6.5)μmol/L,(289.3±7.2)μmol/L,差异有统计学意义(P<0.05),微通道组的肌酐小于标准通道组(P<0.05)。尿素氮分别为(18.0±1.5)mmol/L、(19.0±1.9)mmol/L、(20.3±2.2)mmol/L,差异有统计学意义(P<0.05)。结论:兔模拟经皮肾镜术中,通道孔径越大,其肌酐及尿素氮的值越高,瘢痕面积也越大,对肾损伤越严重。
Objective:To investigate the degree of pathological damage to rabbit kidneys caused by different channel apertures in simulated percutaneous nephroscopy.Methods:Eighteen New Zealand white rabbits were selected,and the experimental animals were divided into three groups:giant channel group,standard channel group and micro channel group according to the difference of intraoperative channel aperture,with 6 in each group.After the intraoperative general anesthesia,the lower back was fully exposed,and a parallel incision was made at the junction of the left side costal margin and the lumbosacral muscle.The length was about 2 cm.The skin and muscle were incised layer by layer,and then punctured with syringe needles of different apertures.Enter the kidney with a depth of 0.5 cm.Use gauze to compress the bleeding,and finally suture the fascia and skin to end the operation.The operation time and the amount of renal bleeding were recorded.Blood was collected from the rabbit ear vein on the 1 st and 3 rd day after the operation to test the related indexes of renal function.One month after the operation,a rabbit kidney specimen was taken for pathological examination,and the scar area was calculated.Results:The operation time of the giant channel group,the standard channel group and the micro channel group were(51.2±3.5)min,(55.1±4.7)min,(51.3±4.2)min,respectively,and the difference was not statistically significant(P>0.05).The bleeding volume was(5.3±0.8)ml,(2.4±0.7)ml,(1.8±0.4)ml,the difference was statistically significant(P<0.05),the hemostasis time was(10.2±1.9)min,(8.1±1.4)min,(3.4±0.8)min,the difference was statistically significant(P<0.05).The creatinine within 1 day after surgery in microchannel group,standard channel group and giant channel group were(263.0±7.6)μmol/L,(282.0±8.5)μmol/L,(298.3±8.7)μmol/L,respectively,the difference was statistical significance(P<0.05).The urea nitrogen within 1 day was(19.0±2.8)mmol/L,(22.0±3.7)mmol/L,(24.3±4.2)mmol/L,and the difference was statistically significant
作者
王超
周昕
董旭
尹新玮
罗玉红
吴长富
吕海迪
周逢海
WANG Chao;ZHOU Xin;DONG Xu;YIN Xinwei;LUO Yuhong;WU Changfu;LV Haidi;ZHOU Fenghai(The First Clinical Medical College,Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China;Department of Urology,Gansu Provincial People′s Hospital)
出处
《西北国防医学杂志》
CAS
2021年第5期308-312,共5页
Medical Journal of National Defending Forces in Northwest China
基金
甘肃省自然科学基金资助项目(17JR5RA333)。
关键词
肾病理损伤
兔
巨大通道
标准通道
微通道
renal pathological damage
rabbit
giant channel
standard channel
microchannel
