兔开放式、经腹及后腹途径腹腔镜肾切除体内肿瘤坏死因子的比较(附视频)  

TNF in open, laparoscopic, and retroperitoneoscopic nephrectomy rabbit models: A comparative study

作　　者：赵海涛[1,2] 吴希庆[3,4] 秦喆[3,4] 

机构地区：[1]内蒙古医科大学第三附属医院 [2]内蒙古包钢医院泌尿外科,包头014010 [3]包头医学院 [4]包钢第三职工医院

出　　处：《中华腔镜泌尿外科杂志（电子版）》2013年第2期49-53,共5页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的建立三种兔肾切除手术模型，检测术后体内TNF的变化探讨体内炎症反应的程度。方法将雄性5~6月龄、体重在2．62—2．94kg的36只獭兔随机分为3组，分别实施经后腹腔开放式（ON）、经腹腹腔镜（LN）、经后腹腔腹腔镜（RN）肾切除术，切取左肾，计算手术时间、麻药使用量、切口长度、手术空间建立时间、切肾时间，于术后即刻、术后1h、2h、6h、12h、24h分别取血，检测肿瘤坏死因子（TNF）。结果三组间比较发现切口长度、手术空间建立时间、切肾时间、手术总时长都有明显差异（P〈0．01）。而两组腔镜手术比较只有手术空间建立时间和切肾时间存在差异。TNF三组组间比较ON〉LN〉RN统计学有显著差异性，两个腔镜手术组间比较LN高于RN，但没有统计学意义。结论使用本方法建立的三种手术方式的肾切除模型容易建立，可以完全模拟临床手术，且经济实用，安全稳定，是对三种；卡式进行基础研究的理想模型；开放手术对机体打击造成的炎症反应大于腔镜手术，两种腹腔镜肾切除手术方式对机体的炎症反应的影响基本相同。Objective To establish three frowns of rabbit nephrectomy models. To detect TNF after the operation and evaluate inflammatory reaction in models. Methods Thirty-six pure rabbit, male, weighting 2.62-2.94 kg, were randomly divided into 3 groups： open （ON）, laparoscopic （LN）, and retroperitoneoscopic nephrectomy （RN）. During operation and post-operation, dose of anesthetics, length of incision, time of creating the operating space, time of kidney excision were recorded and TNF at different sampling time points after the operation were detected. Results There were significant differences among the ON, LN, and RN groups in length of incision, time of creating retroperitoneal space, time of excising kidney, and totas operating time. But only in time of creating retroperitoneal space and total operating time were significantly different between LN, and RN groups. There were significant difference between the ON, LN, and RN groups in TNF： ON 〉LN 〉RN, but no significant difference between LN and RN groups. Conclusions Rabbit model of open, laparoscopic, and retroperitoneoscopic nephrectomy are easily established, completely simulate clinical situation, economic, safe, stable. They are ideal models for three types of nephrectomy. The inflammatory injuries of ON is more serious than other two groups, but it is similar in LN and RN groups.

关 键 词：肾切除 开放手术 腹腔镜 后腹腔 模型 

分 类 号：R699[医药卫生—泌尿科学]