介入临时封堵后外科缝合止血方法对犬肾损伤模型的器官功能保护作用  

Organ protective effects research of surgical hemostasis after temporary intercurrent block in canine kidney injury model

作　　者：曹志强[1] 梁明[2] 刘龙[1] 韩雅玲[2] 梁延春[2] 王军[1] 

机构地区：[1]沈阳军区总医院泌尿外科,辽宁沈阳110840 [2]沈阳军区总医院心血管内科,辽宁沈阳110840

出　　处：《现代泌尿外科杂志》2013年第1期9-12,共4页Journal of Modern Urology

基　　金：全军"十一五"重大专项课题(No.08Z0001);辽宁省科技攻关课题(No.2011225006)

摘　　要：目的观察损伤控制外科中不同止血方法在肾脏损伤治疗过程中的效果。方法将14只杂种犬全麻后,在野外介入方舱手术台内经腹手术制作肾损伤模型,并立即行不同止血方法的损伤控制性外科(DCS)治疗。分为:A手术结扎组、B栓塞组、C临时封堵后缝合组、D对照组。统计并比较1～6周后各组犬/肾功能相关数据的差异。结果 14只犬经损伤控制性治疗均得到有效抢救。术后复查动脉造影,止血均成功;术后复查血红蛋白水平各组之间无统计学差异。术后1周A组犬因肾衰死亡1只,其余13只6周后均存活;损伤肾脏功能恢复情况:A组肾功损失最重,B组次之,C组无明显下降。各组间差异具有统计学意义(P<0.05)。结论 DCS是战场伤、严重创伤治疗的趋势。DCS采用介入临时封堵后外科缝合止血的方法对损伤器官功能保护具有明显优势,值得进一步研究推广。Objective To investigate the efficacy of different methods to treat kidney injuries with damage control surgery. Methods 14 intact canines were made kidney injury models after general anesthesia in the field intervention treatment shelter. The canines were divided into four groups according to different damage control surgeries： A was surgery group, B embolism group, C temporary block group and D, control group. The survival rate and kidney functions of the dogs in different groups 1-6 weeks after the surgery were collected and compared. Results All canines were rescued timely. After surgery, arteriography was conducted and hemostasis was proved. One canine in Group A died one week later because of renal failure and the other 13 canines survived. Group B and C could better protect the damaged renal functions than Group A and D （P〈0.05）. However, Group C did a better job than Group B （P〈0.05）. Conclusion Damage control surgery is a tendency for treating battle injury and severe trauma. Method of temporary blocking blood vessels by intervention and then suturing can protect the damaged organ functions.

关 键 词：损伤控制外科 肾损伤出血 器官功能保护 选择性肾动脉栓塞 外科治疗 

分 类 号：R605.97[医药卫生—急诊医学]