对比增强超声引导经皮穿刺注射止血剂控制闭合性肾外伤活动性出血的实验研究

发布时间：2018-06-21 10:42

本文选题：肾疾病 + 创伤和损伤　；参考：《中国医学影像学杂志》2017年03期

【摘要】：目的超声造影(CEUS)引导经皮穿刺单独注射止血剂或生物胶对控制闭合性肾外伤效果较好,但也存在一定的缺陷。本研究拟探讨CEUS引导经皮穿刺联合注射止血剂和生物胶对控制闭合性肾外伤出血的价值。材料与方法 16只健康大白兔建立闭合性肾外伤活动性出血模型,随机分为穿刺组和开腹组,每组8只。穿刺组采用CEUS引导经皮穿刺将蛇毒血凝酶和生物胶注入肾活动性出血部位,开腹组采用传统的手术缝合止血。术后评估两组疗效,记录治疗时间,术后每周抽血检测肾功能,术后1个月取创面组织行病理检查。结果两组均成功止血。穿刺组及开腹组操作时间分别为(179±30)s和(298±30)s,差异有统计学意义(P0.05)。术后穿刺组血肌酐低于开腹组,差异有统计学意义(P0.05),肾功能恢复也较开腹组快,肾创面愈合较开腹组好。结论 CEUS引导蛇毒血凝酶联合生物胶经皮穿刺控制闭合性肾外伤活动性出血止血效果好、操作便捷、损伤小、恢复快,是一种值得推荐的新型方法。
[Abstract]:Objective CEUS-guided percutaneous injection of hemostatic or biogel is effective in the control of closed renal trauma, but it also has some defects. The purpose of this study was to evaluate the value of CEUs guided percutaneous puncture combined with hemostatic injection and biogel in the control of closed renal trauma hemorrhage. Materials and methods Sixteen healthy rabbits were randomly divided into puncture group (n = 8) and laparotomy group (n = 8). The venom hemagglutinin and biogel were injected into the active renal bleeding site by CEUs guided percutaneous puncture in the puncture group, and the traditional surgical suture was used to stop the bleeding in the open group. The curative effect was evaluated and the time of treatment was recorded. The renal function was measured weekly after operation, and the wound tissue was taken for pathological examination 1 month after operation. Results both groups were successful in hemostasis. The operating time of the puncture group and the open group were 179 卤30s and 298 卤30s, respectively. The difference was statistically significant (P 0.05). The serum creatinine in the puncture group was lower than that in the open group, the difference was statistically significant (P 0.05), the recovery of renal function was faster than that in the open group, and the healing of renal wound was better than that in the open group. Conclusion CEUs guided snake venom hemocoagulase combined with biological glue is a new and recommended method for the control of closed renal trauma bleeding with good hemostatic effect, easy operation, little injury and quick recovery.
【作者单位】：南方医科大学研究生院;广州军区广州总医院超声科;广州军区广州武警指挥学院;
【基金】：广东省科技计划项目(2014A020212255) 广东省自然科学基金项目(2016A030313611) 全军医学科研“十二五”计划课题(CWS12J076)
【分类号】：R692

【参考文献】