微创介入方舱内球囊临时封堵联合外科缝合技术在肾损伤出血犬救治中的应用  

Application of Temporary Closure in Saccule by Intervention Associated with Suture in Treatment of Hemorrhage from Renal Injury in Dogs

作　　者：曹志强[1] 梁明[2] 刘龙[1] 王军[1] 韩雅玲[2] 

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

出　　处：《解放军医药杂志》2014年第1期10-12,15,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：全军"十一五"重大专项课题(08Z0001);全军"十二五"重点课题(BWS12J006);辽宁省科技攻关课题(2011225006)

摘　　要：目的观察介入方舱内球囊临时封堵联合外科缝合止血在创伤性肾损伤出血犬模型中的应用效果。方法 8只健康家犬,随机分为实验组和对照组,每组4只,建立肾损伤出血模型并行肾动脉造影,实验组用球囊导管于二级血管处临时封堵止血,然后外科缝合伤口,撤除封堵气囊,复查造影,游离右侧肾动脉并结扎。对照组采用明胶海绵颗粒选择性肾动脉栓塞止血,游离并结扎右侧肾动脉。记录两组手术时间、肾止血时间、出血量、收缩压和脉搏,术前、术后1 d、2周监测血红蛋白和肾功能变化情况,术后6周观察肾脏组织学和病理损伤评分。结果实验组肾止血时间短于对照组,出血量少于对照组(P<0.05)。两组手术时间、收缩压、脉搏、肾脏病理损伤评分比较差异均无统计学意义(P>0.05)。两组术后1 d血红蛋白较术前降低,血清肌酐、尿素较术前升高,差异有统计学意义(P<0.05)。两组术后2周血红蛋白和肾功能与术前比较以及组间比较差异均无统计学意义(P>0.05)。结论在介入方舱内应用球囊临时封堵联合外科缝合止血是一种安全、有效的肾损伤止血方法。Objective To investigate the effect of temporary interruption in saccule by intervention associated with neoplasty in treatment of hemorrhage from renal injury in dogs. Methods Eight healthy dogs were randomly divided into experiment group （n = 4） and control group （n = 4 ）. Models of hemorrhage from renal injury were established and undertook renal arteriography. The experimental group succeeded in hemostasis with temporary Foley s tube plugging into secondary blood vessels, and then the wounds were sutured. The renal arteriography was performed again after removing the temporary plugging sacci. The right renal arteries were freed and ligated. The control group undertook selective thrombosis of renal artery with gelatin sponge drops, and right renal arteries were freed and ligated. The operation time, renal hemostasis time, bleeding volume, systolic pressure and pulse in the two groups were recorded, changes of hemoglobin and renal function before the operation on the postoperative 1 d and 2 weeks were detected, and changes of renal histology and pathological injury scores 6 weeks after operation were observed. Results The renal hemostasis time and bleeding volume in experiment group were significantly less than those in control group （P 〈 0. 05 ）. There were no statistical differences in operation time, systolic pressure, pulse and pathological injury scores between the two groups （P 〉 0. 05）. The hemoglobin level was significantly decreased, and levels of serum creatinine and urea were significantly increased 1 d after operation （P 〈 0.05）. There were no statistical differences in changes of hemoglobin and renal function before and after operation between the two groups （P 〉 0.05）. Conclusion The temporary interruption by intervention associated with neoplasty is safe and effective in treatment of hemorrhage from renal injury.

关 键 词：微创介入方舱 肾 创伤和损伤 栓塞 治疗性 狗 

分 类 号：R-332[医药卫生] R692