一种新的犬创伤性肾出血止血模型建立及临床意义  

Construction and Clinical Significance of a New Kind of Hemorrhage and Hemostasis Model Using Canine Traumatic Kidney

作　　者：曹志强[1] 刘龙[1] 王军[1] 梁明[2] 韩雅玲[2] 

机构地区：[1]沈阳军区总医院泌尿外科,辽宁沈阳110016 [2]沈阳军区总医院心血管内科,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2014年第3期183-184,190,共3页Trauma and Critical Care Medicine

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

摘　　要：目的动物实验验证一种新的肾损伤止血方法的可行性，探讨其临床意义。方法实验用犬8只，超声引导下用尖刀于12肋下刺入肾脏，造肾损伤出血模型，立即于介入手术台上行肾动脉造影，用临时封堵球囊于二级血管处临时封堵止血，并手术探查，清除血肿后，裂口用2～0可吸收线缝合。撤除封堵球囊，复查造影。记录手术时间、肾缺血时间、手术出血量，术后监测血细胞分析、肾功能。结果所有实验犬均抢救成功，术后复查造影让实止血成功。手术时间为27．5—45．4min，平均39．5min，肾缺血时间（球囊封堵时间）为12．5—15．3min，平均14．2min，出血量170～230mL，平均199．8mL。缝合后术中观察及复查造影证实止血成功，术后1—2d肉眼血尿消失。血红蛋白、血清肌酐等实验室指标术前与术后2周比较差异无统计学意义（P〉0．05）。结论介入临时封堵联合外科缝合止血可有效保护受损肾功能，是一种安全有效的器官损伤止血方法。Objective To investigate the clinical significance and efficacy of a new kind of method to treat kidney injuries. Methods Eight dogs were penetrated into kidney using a sharp-pointed knife under the guidance of ultrasound to made re- nal injury bleeding model. We executed renal artery angiography on the intervention operation table, and succeeded in hemo- stasis with temporm3- plugging saccule in secondary vascular place. Then we had surgical exploration, removed the hemato- ma,sutured wound with 2 -0 absorbable thread. After removing the temporary plugging saccule,we rechecked renal artery angiography, and recorded the operation time, renal ischemia time, operation amount of bleeding, blood cell analysis, ren＇al function. Results All canines were rescued timely. After surgery ,arteriography was conducted and hemostasis was proved. Eight dogs operalion time：27.5 ~45.4 min （39.5 rain） ,renal ischemia time： 12.5 - 15.3 rain（ 14.2 rain） ,amount of bleeding： 170 -230 mL（ 199.8 mL）. We proved hemostatic success by intraoperative observation and angiography alter su- turing. Macroscopic hematuria disappeared 1 or 2 days later. There are no statistically difference in the main laboratory inde- xes between preoperative and postoperative 2 weeks （ P 〉 0.05 ）. Conclusion Method of temporary blocking blood vessels by intervention and then suturing can protect the damaged renal functions. It is a safe and effetive hemostasis method for kidney injurys.

关 键 词：肾损伤 肾动脉栓塞 实验外科 肾功能保护 

分 类 号：R641[医药卫生—外科学] R332[医药卫生—临床医学]