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| 院前明胶海绵栓塞治疗肾血管损伤的动物研究* |
| Animal study of pre-hospital gelatin sponge embolization for renal vascular injury* |
| 投稿时间：2013-01-25 修订日期：2013-01-30 |
| DOI： |
| 中文关键词: 综合手术救治方舱 肾动脉栓塞 介入治疗 明胶海绵 动物实验 |
| 英文关键词: comprehensive operation rescue shelter renal artery embolization interventional therapy gelatin sponge animal experiment |
| 基金项目:全军“十二五”科研重点项目(课题编号：BWS12J006)；辽宁省科技攻关课题 (课题编号2011225006) |
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| 中文摘要: |
| 目的 探讨在新型综合手术救治方舱中明胶海绵栓塞治疗肾血管损伤的可行性和疗效。方法 在新型综合手术救治方舱中构建3例动物肾腹(背)干动脉损伤模型、3例肾段动脉损伤模型,先用1mm×1mm×1mm明胶海绵颗粒对损伤血管进行栓塞治疗,若未能止血,改用2mm×2mm×2mm颗粒栓塞,观察栓塞后15分钟、1月后的肾动脉造影,栓塞后1月的组织病理表现。结果 3例肾段动脉和1例肾腹干动脉使用1mm×1mm×1mm明胶海绵颗粒一次栓塞成功；1例肾腹干动脉和1例肾背干动脉用1mm×1mm×1mm颗粒栓塞未能完全止血,改用2mm×2mm×2mm颗粒栓塞成功。6例动物术后生命体征平稳,全部存活,一个月后造影复查见栓塞动脉未再通,但其余分支动脉血供得到保留。大体标本观栓塞侧肾明显缩小,未见脓腔和脓性分泌物,病理切片示栓塞后局部肾组织有不同范围缺血性梗死。结论 野战方舱中明胶海绵栓塞治疗出血效果明确,对于一般肾血管损伤定位准确,止血迅速、彻底,有良好的可行性和疗效。 |
| 英文摘要: |
| Objective This study aimed to evaluate feasibility and effectiveness of the gelatin sponge embolization for renal vascular damage in the novel comprehensive operation rescue shelter. Methods Three cases of renal truncus arteriosus injury model, three cases of animal renal segmental artery injury model were made in the comprehensive operation rescue shelter. All the injured renal arteries were embolizated with 1mm × 1mm × 1mm gelatin sponge particles first. If the embolization failed, 2mm × 2mm × 2mm particles would be used. Renal artery angiography and histological examination was performed after one month. Results Three cases of animal renal segmental artery injury model and one case of truncus ventralis injury model was embolizated with 1mm × 1mm × 1mm gelatin sponge particles once successfully. Two cases of renal truncus arteriosus failed to stop bleeding after embolization with 1mm × 1mm × 1mm gelatin sponge particles, then 2mm × 2mm × 2mm particles succeeded. Postoperative vital signs of six animals were stable and all survived. Angiography after 1 month detected no recanalization of the occluded renal arteries but the blood supply of the remaining branches was preserved. The embolized kidneys atrophied significantly without abscess cavity and purulent discharge. Pathological section showed the localized renal tissue had various range of ischemic infarction. Conclusion Gelatin sponge embolization is a safe and effective treatment for renal vascular injury in the comprehensive operation rescue shelter, having good effect of hemostasis and providing the possibility for subsequent treatment with accurate angiographic positioning. |
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