睾丸扭转后不同复位方法及其效果的实验研究

发布时间：2018-01-19 05:32

本文关键词： 睾丸扭转缺血再灌注减压术比较　出处：《大理学院》2013年硕士论文　论文类型：学位论文

【摘要】：目的:建立雄兔睾丸扭转复位模型，探讨睾丸扭转复位中睾丸内减压和缺血再灌注间的联系，对照研究单纯复位和减容复位对睾丸扭转复位的影响并评价其预后，为睾丸扭转复位后的干预提供新的思路。并就一侧睾丸受损是否对对侧睾丸产生影响进行探讨。方法:18只雄性大白兔随机分成三组：假手术组（A）、单纯复位组（B组）、减容复位组(C组),每组6只。B组、C组建立雄兔睾丸扭转模型后行超声学检查，B组单纯复位（干预侧为B1、对侧B2），C组减容复位（干预侧为C1、对侧C2）,1d后测定各组睾丸组织超氧化物歧化酶(SOD)含量；HE染色后光镜下观察睾丸组织的病理学改变,并行Johnsen's评分；1w超声检查，处死雄兔，同样测定SOD,行病理学检查。结果:精索扭转后4h后彩色多普勒超声检查睾丸血供减少至术前的35％－50％，组织超氧化物歧化酶(SOD)含量和Johnsen 's评分分别是：（106.4±8.16）U/mg、（9.13±0.16）分，，与假手术A比较有显著差异（P0.05）,睾丸扭转模型建立成功。1w后各组彩色多普勒超声检查睾丸血供减少至术前的分别是：B1组10％～25％，C1组30％～50％，B2组90～95％，C1血供比B1明显丰富、B2血供与A比较略减少；组织SOD含量:1d和1w分别为：B1（98.20±9.95）U/mg、（83.28±10.00）U/mg，C1（110.91±12.16）U/mg、（100.78±11.30）U/mg；B1，C1与A比较有显著差异（P0.05），B1与C1比较有显著差异（P0.05）。对侧：B2（128.90±8.39）U/mg、（116.16±9.34）U/mg，C2（129.87±8.94）U/mg、（134.40±8.17）U/mg；1d各组比较无统计学意义（P0.05）；1w：A与B2比较有显著差异（P0.05）；A与C2比较无显著差异(P0.05)；C2与B2比较有显著差异（P0.05）。Johnsen 's评分:1d和1w.B1分别为（8.49±0.18）分、（4.95±0.43）分，C1（8.93±0.08）分、（7.76±0.33）分,B1.C1与A比较有显著差异（P0.05），C1与B1比较有显著差异(P 0.05)。对侧B2与C2比较无显著差异(P0.05),但有形态学的改变。结论:睾丸扭转复位缺血再灌注后随着时间越长，损伤越明显；睾丸内减压方法可更有利于扭转复位侧睾丸的恢复；一侧睾丸受损随着时间的延长对对侧睾丸也有一定影响，减容复位方可较单纯复位有效缓解对对侧睾丸的损伤。
[Abstract]:Objective: to establish a model of testicular torsion reduction in male rabbits, and to explore the relationship between intratesticular decompression and ischemia-reperfusion during testicular torsion reduction. To study the effect of simple reduction and volume reduction on testicular torsion reduction and evaluate its prognosis. To provide a new idea for the intervention after testicular torsion reduction, and to discuss whether the unilateral testicular injury has an effect on the contralateral testis. Methods 18 male white rabbits were randomly divided into three groups: sham-operated group, simple reduction group, and reduced volume reduction group, with 6 rats in each group. After the establishment of testicular torsion model in group C, simple reduction was performed in group B (intervention side was B1, contralateral group B _ 2 was reduced by volume reduction) (intervention side was C _ 1, contralateral C _ 2). The content of superoxide dismutase (SOD) in testicular tissue of each group was measured 1 day later. After HE staining, the pathological changes of testis were observed under light microscope, and Johnsen's score was used. After 1 week ultrasound examination, male rabbits were killed, SOD was also measured and pathological examination was made. Results: four hours after spermatic torsion, the testicular blood supply was reduced to 35-50% by color Doppler ultrasonography. The content of superoxide dismutase (SOD) and the Johnsen score were 106.4 卤8.16U / mg / m ~ (-1) 卤9.13 卤0.16, respectively. Compared with sham-operation A, there was a significant difference (P0.05%). After the establishment of testicular torsion model, the blood supply of testicular blood was reduced to 25% in group B _ 1 after the establishment of testicular torsion model. The blood supply of C _ 1 in group C _ 1 was significantly richer than that of B _ 1 in group B _ 2, and the blood supply of group B _ 2 was slightly lower than that of group A; The SOD content of the tissue was 98.20 卤9.95 U / mg for 1 d and 83.28 卤10.00 U / mg for 1 day and 1 week, respectively. C1C 110.91 卤12.16 U / MGN 100.78 卤11.30 U / mg; There was significant difference between B1C 1 and A (P 0.05) and C 1 (P 0.05). The contralateral ratio of B2C 1 was 128.90 卤8.39 U / mg. 116.16 卤9.34 U / mgt C2N 129.87 卤8.94 U / MGN 134.40 卤8.17U / mg; On the 1st day, there was no significant difference in each group (P 0.05). 1 w: a was significantly different from B2 (P 0.05); There was no significant difference between A and C2 (P 0.05). There was significant difference between C2 and B2 (P 0.05). Johnsen's scores of 1 d and 1w.B1 were 8.49 卤0.18 and 4.95 卤0.43, respectively. There was a significant difference between C _ (1) and A (P _ (0.05)) and C _ (1) (8.93 卤0.08) and B _ (1.C1), respectively (7.76 卤0.33). There was significant difference between C1 and B1 (P0.05), but there was no significant difference between the contralateral B2 and C2, but there were morphological changes. Conclusion: the longer the time is, the more obvious the injury is after testicular torsion reduction and ischemia reperfusion. The method of intratesticular decompression is more beneficial to the recovery of the torsional reduction side of testis. Unilateral testicular damage also had some effect on contralateral testis with the extension of time. Volume reduction and reduction were more effective than simple reduction to alleviate the damage to contralateral testis.
【学位授予单位】：大理学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R726.9

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