对比增强超声引导经皮穿刺注射止血剂控制闭合性肾外伤活动性出血的实验研究  

Contrast-enhanced Ultrasound Guided Percutaneous Puncture Injecting for Hemostatic Control of Active Bleeding of Closed Renal Trauma:An Experimental Study

作　　者：王青[1,2] 王珊珊[3] 杨涛炜 何晶玲 王莎莎[2] 李叶阔[1,2] 

机构地区：[1]南方医科大学研究生院,广东广州510515 [2]广州军区广州总医院超声科,广东广州510010 [3]广州军区广州武警指挥学院,广东广州510440

出　　处：《中国医学影像学杂志》2017年第3期161-164,共4页Chinese Journal of Medical Imaging

基　　金：广东省科技计划项目(2014A020212255);广东省自然科学基金项目(2016A030313611);全军医学科研"十二五"计划课题(CWS12J076)

摘　　要：目的超声造影(CEUS)引导经皮穿刺单独注射止血剂或生物胶对控制闭合性肾外伤效果较好,但也存在一定的缺陷。本研究拟探讨CEUS引导经皮穿刺联合注射止血剂和生物胶对控制闭合性肾外伤出血的价值。材料与方法 16只健康大白兔建立闭合性肾外伤活动性出血模型,随机分为穿刺组和开腹组,每组8只。穿刺组采用CEUS引导经皮穿刺将蛇毒血凝酶和生物胶注入肾活动性出血部位,开腹组采用传统的手术缝合止血。术后评估两组疗效,记录治疗时间,术后每周抽血检测肾功能,术后1个月取创面组织行病理检查。结果两组均成功止血。穿刺组及开腹组操作时间分别为(179±30)s和(298±30)s,差异有统计学意义(P<0.05)。术后穿刺组血肌酐低于开腹组,差异有统计学意义(P<0.05),肾功能恢复也较开腹组快,肾创面愈合较开腹组好。结论 CEUS引导蛇毒血凝酶联合生物胶经皮穿刺控制闭合性肾外伤活动性出血止血效果好、操作便捷、损伤小、恢复快,是一种值得推荐的新型方法。Purpose Contrast-enhanced ultrasound（CEUS） guided percutaneous puncture injection of hemostatic agents or biological glue is good for the control of closed renal trauma, but there are also some shortcomings. This study aims to explore the effect of CEUS guided percutaneous puncture injection of hemostatic agent and xanthan gum on the control of closed renal trauma hemorrhage. Materials and Methods Sixteen healthy white rabbits were established closed renal trauma models of active bleeding, and were randomly divided into two groups, puncture and laparotomy group. The puncture group was treated with CEUS guided percutaneous injection of snake venom enzyme and biological glue into the active renal hemorrhage. The laparotomy group was treated with traditional surgical suture. The therapeutic effect of two groups was evaluated after operation. The treatment time was recorded, and the renal function was measured every week after the operation. The pathological examination of the wound tissue was performed 1 month after operation. Results Two groups were successful hemostasis. The operation time of puncture group and open group was（179±30） s and（298±30） s, respectively, and the difference was statistically significant（P〈0.05）. After operation, the serum creatinine of the puncture group was lower than that of the laparotomy group, and the difference was statistically significant（P〈0.05）. The recovery of renal function of the puncture group was faster than that of the laparotomy group, and the renal wound healing was better than that of the laparotomy group. Conclusion The effect of CEUS guided percutaneous puncture injection of snake venom enzyme combined with biological glue in the treatment of closed renal trauma hemorrhage is good, which is a new method worth recommending for easy operation, small damage and quick recovery.

关 键 词：肾疾病 创伤和损伤 出血 超声检查 造影剂 穿刺术 止血药 疾病模型 动物 兔 

分 类 号：R-33[医药卫生] R445.1