双侧输尿管完全梗阻时段对家兔肾功能的影响.doc

《双侧输尿管完全梗阻时段对家兔肾功能的影响.doc》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、双侧输尿管完全梗阻时段对家兔肾功能的影响作者：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24hBUN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

2、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26h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:ObjectiveToexaminethelengthoftimebetwee

3、ncompletebilateralureteralobstructionandtheoccurrenceofsevereazotemiaandtoinvestigatetherelationshipbetweenremovalofobstructiontimeandrenalfunctionrecovery.Methods15healthyadultrabbitsweighed2～4kgunderwentintravenousgeneralanesthesiawith20%urethane.Bilateraluret

4、eralligationwasperformedforalltherabbits.Within72hours,theobstructionligationwasremovedforeachgroup(threerabbitseach)every24hour.Bloodureanitrogen(BUN)andcreatinine(Cr)weredetermined.ResultsAtthefirst24hourafterligationobstruction,BUNandCrlevelselevatedsignifica

5、ntly,comparedtothosebeforeoperation,thelevelsincreasedmoresignificantlywiththeobstructionprolonged.Aftertheligationwasreleasedatthefirstandthesecond24hours,renalfunctionrecoveredrapidly,theurinevolumewaselevatedandtheprognosiswasgood.Aftertheligationwasreleaseda

6、tthethirdandthefourth24hours,theBUNandCrlevelselevatedmoresignificantly,renalfunctioncouldnotberecovered,thesymptomsofuremiainrabbitspresentedmoreobviously,andsevereazotemiaworsened,andrabbitsdiedatthe26thhourandthe2ndhouraftertheligationwasreleased.ConclusionWh

7、enbilateralureterswerecompletelyobstructedandsevereazotemiaoccurred,theprognosismaybebetterandtherenalfunctioncanberecoverediftheobstructionisremovedwithin48hours.Iftheobstructionwillberemovedinmorethan72hours,4therenalfunctioncannotberecoveredandtheprognosisisw

8、orse.　　Keywords:ureteralobstruction;kidneyfailure,acute;bloodureanitrogen;creatinine;rabbits,animalexperiments　　　　尿路梗阻的病因较多，其中机械性梗阻较多见，常由输尿管各种病变引起，如肾盂输尿管连接处狭窄、输尿管瓣膜、息