肾脏摘除术治疗犬单侧肾盂积水的效果研究

发布时间：2018-02-04 21:49

  本文关键词： 犬肾盂积水 肾脏摘除疗法 血常规与生化指标 B超形态变化 组织变化　出处：《南京农业大学》2015年硕士论文　论文类型：学位论文

【摘要】：肾盂积水是目前小动物临床的常见疾病之一,其病因是尿路发生阻塞,根据发生阻塞的部位和程度不同,有不同的治疗方法。患侧肾脏摘除法适用于单侧肾脏发生肾盂积水的治疗。据文献报道,单侧肾脏发生梗阻而致肾盂积水时,对侧肾脏会代偿性生长,有学者研究发现,代偿肾脏在代偿性生长的过程中受到患侧肾脏的影响,会发生细胞凋亡并受到一定损害,且这种伤害与肾盂积水发生的时间及阻塞程度有关。本试验主要探究使用肾脏摘除法治疗单侧肾盂积水时,进行手术的时机对犬及其健侧肾脏的代偿生长是否有影响。为临床上使用单侧肾脏摘除法治疗犬肾脏积水提供参考依据。试验Ⅰ、犬肾盂积水模型的建立为了研究犬发生肾盂积水使用去肾治疗法对犬的影响,首先应建立犬肾盂积水的模型。方法:对试验犬进行健康检查以确定试验犬的健康状况都良好后,将9只试验犬随机分为3组。对每只试验犬进行手术,结扎左侧输尿管。输尿管阻塞后导致左侧肾脏肾盂积水,以B超检查观察肾盂积水的情况。结果:输尿管结扎后,肾脏发生肾盂积水,B超检查可见肾脏体积增大,输尿管管径增大。犬肾盂积水模型建立成功。试验Ⅱ、肾脏摘除术治疗犬单侧肾盂积水对犬血常规及生化指标的影响研究肾盂积水发生后不同时间点摘除患肾后对犬血常规及生化指标的影响。方法:选取9只健康成年中华田园犬,将其分为A、B、C三组,每组3只。对9只犬全部进行左侧输尿管结扎。于结扎后1周、2周、4周后,分别对A、B、C三组试验犬进行左侧肾脏摘除术。分别于肾脏摘除手术前一天,手术后第1、2、3、4、7、14、28、42天采集试验犬血液,检测血常规和生化指标。结果:肾盂积水发生后不同时间点摘除患肾后,犬的大部分血常规指标变化无明显差异,仅白细胞和粒细胞在后期出现显著差异性。血清肌酐和尿素氮都呈逐渐上升的趋势,在28天后各组差异显著。血清磷浓度呈上升趋势,各天三组的数据相比无明显差异。由此可见,肾脏摘除术治疗犬单侧肾盂积水是可行的,且施行手术的时间越晚,对犬血常规及生化指标的影响越大。试验Ⅲ、肾脏摘除术治疗犬单侧肾盂积水对犬代偿肾脏构型变化的影响研究肾盂积水不同时间后摘除患肾,对健侧肾脏形态结构的影响。方法:选取9只健康成年中华田园犬,随机分为A、B、C三个组,每组3只。对每只犬进行左侧输尿管结扎手术。在输尿管结扎术后的第1、2、4周,分别对A、B、C组犬进行左侧肾脏摘除术。在各组试验犬进行肾脏摘除术前1天,术后第1、2、3、4、7、14、28、42天,分别对A、B、C组的试验犬进行右肾B超检查,记录右肾长、肾宽及肾皮质厚度。结果:肾脏摘除后42天,A、B组的代偿肾脏肾长分别较手术前增大了 9.85%和4.12%,而C组较术前减小了 1.73%,A、B组肾宽分别增大了 16.99%,6.79%,而C组减小了 2.14%。肾脏皮质的变化不大,手术后第42天与手术前相比,A、B组仅分别增大了 0.61%、0.62%,C组无变化。由上可知,肾脏摘除术治疗犬单侧肾盂积水时,患侧肾脏在体内的留存时间对肾脏B超形态影响不显著。试验Ⅳ、肾脏摘除术治疗犬肾盂积水对单侧犬代偿肾脏组织学变化的影响肾盂积水发生后不同时间后摘除肾脏,犬代偿肾脏会发生组织学的变化,通过研究代偿肾脏组织学的变化来观察摘除肾脏手术对犬的影响。方法:选取9只健康成年中华田园犬,随机分为A、B、C三个组,每组3只。对每只犬进行左侧输尿管结扎手术。在输尿管结扎术后的第1、2、4周,分别对A、B、C组犬进行左侧肾脏摘除术。在肾脏摘除术后第42天后,采集代偿肾(右肾)组织,样品置于4%%甲醛溶液中固定,4℃保存,并对其进行常规组织病理学检查。结果:A组犬右肾肾小球形态完整,体积无明显变化,没有明显分叶,肾小管上皮轻微水肿,未见有上皮细胞脱落,肾间质无明显变化。B组犬右肾肾小球体积轻微增大,肾小球囊腔变小,血管球略有分叶,肾小管上皮水肿,部分脱落,管腔扩张。肾间质水肿,蛋白管型。C组犬右肾组织可见部分肾小球充血,体积减小,分叶明显,系膜细胞增生,球囊间隙增大。肾小管上皮变性坏死,在管腔内可见脱落的上皮细胞,可见部分出现蛋白管型,肾间质炎性浸润。由此可知,肾脏摘除术治疗犬单侧肾盂积水时,患侧肾脏在体内的留存时间越长对肾脏组织影响越大。
[Abstract]:Hydronephrosis is a common disease of the small animal clinic at present, the etiology of urinary tract obstruction is occurred, according to the location and degree of obstruction, with different treatment methods. The ipsilateral kidney removal method is suitable for treating unilateral kidney hydronephrosis. It is reported that the single side kidney obstruction with hydronephrosis. The contralateral kidney will compensatory growth, some scholars have found that the compensatory kidney by affected kidneys during compensatory growth, apoptosis will occur and damage, and the damage time and degree of obstruction and hydronephrosis occurred. This experiment mainly explore the use of kidney removal to treat unilateral hydronephrosis when does the operation time have effect on dogs and contralateral kidney compensatory growth. For the clinical use of unilateral renal extraction treatment of canine kidney seeper provide reference. In Experiment I, canine hydronephrosis model in order to study the occurrence of canine hydronephrosis using renal therapy effect on dog, should first establish a canine hydronephrosis model. Methods: health examination of test dogs to determine test dogs have a good health condition, 9 experimental dogs were randomly divided into 3 groups. Operation of each canine, ligation of the left ureter. Ureteral obstruction after left renal hydronephrosis, hydronephrosis by ultrasound observation. Results: ureteral ligation, kidney hydronephrosis, ultrasound examination showed kidney volume increased, ureter diameter increases. Hydronephrosis canine model was established successfully. The test of the kidney study on removal of hydronephrosis operation treatment of unilateral hydronephrosis on canine blood routine and biochemical indexes of different time points after removal effect on canine blood routine and biochemical indexes of kidney. Methods: 9 healthy adult dogs Chinese garden, which is divided into A, B, C three groups, 3 rats in each group. All were left ureteral ligation in 9 dogs. After ligation of 1 weeks, 2 weeks, 4 weeks, respectively A, B, C three groups of experimental dogs left kidney resection in the removal of kidney. The day before operation, postoperative day 1,2,3,4,7,14,28,42 of canine blood collection, blood routine and biochemical indexes. Results: hydronephrosis occurs at different time points after removal of the kidney, no significant difference between the change of blood routine index of most dogs, only white blood cells and granulocytes appeared significant difference in serum in later stage. Creatinine and urea nitrogen were increased gradually in 28 days, significant differences between each group. Serum phosphorus concentration increased, there was no significant difference between the three day group data. Thus, the renal resection treatment of unilateral hydronephrosis is feasible, and the implementation of the operation of the late time, the 鐘�琛�甯歌�勫強鐢熷寲鎸囨爣鐨勫奖鍝嶈秺澶�.璇曢獙鈪，

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