双侧输尿管完全梗阻时段对家兔肾功能影响.docVIP

双侧输尿管完全梗阻时段对家兔肾功能影响 　 作者：黄玮昕，刘俊福，刘建驰，谢明心，代何，梁腾兵，梁超越，陈晖 【摘要】 目的 探讨家兔在双侧输尿管完全梗阻至重度氮质血症发生时段及解除梗阻时段和肾功能恢复的关系。方法 健康成年家兔15只，体重2～4kg，以20％乌拉坦经耳缘静脉注射全身麻醉，手术结扎双侧输尿管，从第一个24h起，每24h解除一组家兔(3只)输尿管梗阻状态，并抽血测定血清尿素氮(BUN)和肌酐(Cr)数值。结果 手术后第一个24h BUN和Cr值比术前显著上升，并随着梗阻时间的延长而上升。在第一和第二个24h解除梗阻后，肾功能迅速得以恢复，出现多尿，预后良好。在第三和第四个24h解除梗阻后，D组和E组BUN和Cr值愈加上升，肾功能未见好转，家兔尿毒症临床表现愈加明显，重度氮质血症加重，并分别于解除梗阻后26 h和2h死亡。结论 当输尿管完全梗阻并出现重度氮质血症后在实施梗阻后的第二个24h内解除梗阻，可有效恢复肾功能，预后较好；若≥72h解除梗阻，则肾功能无法恢复，预后较差。 【关键词】 输尿管梗阻；肾功能衰竭，急性；血尿素氮；肌酐；兔，动物实验 　　Abstract: Objective To examine the length of time between complete bilateral ureteral obstruction and the occurrence of severe azotemia and to investigate the relationship between removal of obstruction time and renal function recovery. Methods 15 healthy adult rabbits weighed 2～4kg underwent intravenous general anesthesia with 20% urethane. Bilateral ureteral ligation was performed for all the rabbits. Within 72 hours, the obstruction ligation was removed for each group (three rabbits each) every 24 hour. Blood urea nitrogen (BUN) and creatinine (Cr) were determined. Results At the first 24 hour after ligation obstruction, BUN and Cr levels elevated significantly, compared to those before operation, the levels increased more significantly with the obstruction prolonged. After the ligation was released at the first and the second 24 hours, renal function recovered rapidly, the urine volume was elevated and the prognosis was good. After the ligation was released at the third and the fourth 24 hours, the BUN and Cr levels elevated more significantly, renal function could not be recovered, the symptoms of uremia in rabbits presented more obviously, and severe azotemia worsened, and rabbits died at the 26th hour and the 2nd hour after the ligation was released. Conclusion When bilateral ureters were completely obstructed and severe azotemia occurred, the prognosis may be better and the renal function can be recovered if the obstruction is removed within 48 hours. If the obstruction will be