可降解输尿管支架对输尿管战创伤后肾功能的保护作用  

Protective effect of biodegradable ureteral stent on renal function after traumatie ureter injury

作　　者：李钢[1] 符伟军[1] 洪宝发[1] 蔡伟[1] 王忠新[1] 曹磊[1] 徐福强[1] 刘自来[1] 崔福斋[1] 宋强[1] 张旭[1] 

机构地区：[1]解放军总医院泌尿外科,北京100853

出　　处：《中华创伤杂志》2010年第11期1043-1046,共4页Chinese Journal of Trauma

基　　金：北京市自然科学基金资助项目（2092029）;全军“十一五”计划项目面上课题资助项目（06MA298）;解放军总医院科技创新苗圃基金资助项目（08MP-08）

摘　　要：目的 建立一种新的输尿管战创伤动物模型,研究生物可降解输尿管支架在输尿管战创伤治疗中对肾功能的保护作用.方法 使用自行研制的火器弹片伤制造模具,对模型建立组9只比格犬的随机一侧输尿管制造火器弹片伤后清创缝合,分别于术后40,80,120 d进行静脉肾盂造影、肾图评估.再对阳性对照组9只比格犬的双侧输尿管均制造火器弹片伤,随机一侧放置聚乳酸可降解输尿管支架,另一侧放置双J管,对其结果进行评估.结果 模型建立组损伤侧术后出现肾积水,肾脏浓聚,排泄功能下降.阳性对照组术后双侧均未见明显肾盂、输尿管积水;双肾分浓缩率比值（可降解支架/双J管）上升,半排时间比值（可降解支架/双J管）上升,但差异均无统计学意义;可降解支架侧未见膀胱输尿管反流（vesico-ureteral reflux,VUR）,双J管侧有反流.结论 成功建立了比格犬火器弹片伤动物模型.可降解支架与双J管均起到了支撑、引流作用;可降解支架可有效保护输尿管膀胱交界处的抗反流功能.Objective To establish a new canine model of ureter trauma to observe the protective effect of biodegradable ureteral stent on renal function following traumatic ureter injury. Methods A self-made device was used to make firearm fragment wounds unilaterally on the ureters in nine Beagle dogs （model group）. The wounds were debrided and sutured and the results were evaluated by using intravenous pyelography （IVP） and radioactive renography at 40, 80 and 120 days postoperatively. Firearm fragment wounds were made to the bilateral ureters of nine Beagle dogs in the positive control group, in which a biodegradable stent was placed in one side and a double-J stent placed in the other side. Results In model group, hydronephrosis and hydroureter occurred and got worse postoperatively on the wounded side in all nine Beagle dogs, while none of these symptoms were found in any animals in the control group. The ratios of biodegradable stent side to double-J stent side were increased in renal patial concertration index and half time of kidney washout, but neither showed significant differences. However,vesicoureteral reflux （VUR） was not found in the biodegradable stent side, but in the double -J stent side. Conclusions A new canine model of firearm fragment wounds is successfully developed. Both the biodegradable and double-J stent play important roles in support and drainage and show no significant difference in aspects of renal uptake and half time of kidney washout. The biodegradable stent can effectively prevent VUR.

关 键 词：火器 输尿管 支架 膀胱输尿管反流 

分 类 号：R686[医药卫生—骨科学]