| 丁军陈仙△ 杨帆邱伟彬张彪罗志刚.肾盂灌注冲洗对肾脏功能和结构的影响[J].,2011,11(5):850-853 |
| 肾盂灌注冲洗对肾脏功能和结构的影响 |
| Effects of renal pelvis infusion on renal function and structure |
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| DOI： |
| 中文关键词: 肾盂灌注 压力 肾单位 损伤 |
| 英文关键词: renal pelvis infusion Pressure Nephron Injure |
| 基金项目:湖南省科技厅科研基金课题（2008FJ3221） |
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| 中文摘要: |
| 目的：探讨经皮肾镜碎石术肾盂灌注冲洗压对肾脏结构和功能的影响。方法：建立20 头活体猪高压肾盂冲洗模型，建立24F
肾造瘘通道，分别在0mmHg（作自身对照，只造瘘不灌注）、150mmHg、200mmHg、250mmHg、300mmHg 压力下各冲洗30 分钟。术
中取肾组织送病理检查，监测肾单位光镜和电镜下的形态学改变；术后5 天留取尿标本，应用免疫比浊测定法（ITM）检测尿微量
白蛋白(ALB)和β2- 微球蛋白(β2-MG)；并于术后第5 天再次取肾组织行病理检查观察肾单位的形态学改变。结果：所有灌注组术
后都出现尿蛋白的增高，术后第1 天和术前相比，都有显著差异（P<0.01）。形态学观察：当肾盂灌注冲洗压在150-200mmHg 时，光
镜下观察见肾小囊腔轻度扩张，压力超过250mmHg，肾小囊腔见红细胞和蛋白渗出物，肾小管扩张。电镜下见肾近曲小管上皮细
胞内空泡形成，微绒毛排列杂乱、稀疏、部分微绒毛脱落。结论：肾盂灌注冲洗安全压不应超过200mmHg。 |
| 英文摘要: |
| Objective: To explore the influence of kidney's structure and function of intrapelvic perfusion under percutaneous
nephrolithotripsy (PCNL). Methods: High-pressure intrapelvic perfusion model was established under different pressure for twenty
swines, to establish 24F nephrostomy established channels, in 0 mmHg (for self-control, only ostomy not perfusion), 150mmHg,
200mmHg, 250mmHg, 300mmHg pressure for 30 minutes intrapelvic perfusion respectively. The renal biopsy specimens were used to
pathologic examination and were taken for observed the morphological changes under light and electron microscopy during an operation;
The urine samples were collected and applied Immune than turbidity method detection of urinary albumin (ALB) and β2-microglobulin
(β2-MG);after operation for 5 days; and the 5 day after operation, renal specimens were taken for observed the renal pathology and renal
unit of the morphological changes again. Result: All the Infusion group had the change of urinary protein，the difference of model was of
statistical significance between the before and the first day after treatment (P<0. 01). Morphological observation: When we flushed the
pressure at 150-200mmHg, we could see the slight expansion of renal cysts in light microscope. When the pressure over 250mmHg, there
are red blood cells and protein exudations in renal cysts as well as the tubular dilation in the same area. There are vacuolizations,
microvillus arranged in cluttered and sparse, some microvillus was shaded in electron microscopy. Conclusion: The ideal intrapelvic
perfusion for PNL was lower than 200mmHg. |
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