肾静脉上及肝上结扎家兔下腔静脉对肾肝功能及血栓通对肾功能的影响

发布时间：2018-05-18 16:02

本文选题：IVC + 肾静脉上　；参考：《郑州大学》2016年硕士论文

【摘要】：目的:本研究通过在肾静脉上及肝上平面结扎家兔下腔静脉(inferior vene cava,IVC),并于肾静脉上结扎IVC后使用血栓通药物,观察术后不同时间肾、肝功能指标改变及病理学改变规律,以期为下腔静脉阻塞性疾病的外科治疗提供理论依据。方法:选取5个月日本健康大耳兔,由郑州大学动物实验中心提供,体重2.0-2.3Kg,雌雄不限。将家兔随机分为五组:A正常对照组:7只,心脏采血后检测血清肌酐(Scr)、血清尿素(Sur)、肾小球率过滤(GFR)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST),乳酸脱氢酶(LDH),并取肾脏、肝脏做病理组织检查。采血、取肾、取肝完成后处死动物。B假手术组:28只,于中上腹部取长约10cm手术切口,进入腹腔,暴露出IVC后即逐层关闭腹壁。分别于术后1、3、5、7d心脏采血检测Scr、Sur、GFR、ALT、AST、LDH,并取肾脏、肝脏放置于福尔马林溶液中保存。采血取肾后,家兔全部处死。C单纯结扎肾静脉上IVC组:28只,打开腹腔,暴露右肾静脉及其平面以上IVC(家兔右肾静脉高于左肾静脉),结扎IVC,分别同B组于每个时间点取7只家兔,采血检测肾功能,取肾后家兔全部处死。D血栓通治疗组:28只,术前3天开始肌肉注射血栓通注射液,(广西梧州制药股份有限公司生产,批号:Z20025652),剂量为10mg/Kg体重,每天注射1次。手术方法同C组,并同C组采血取肾进行检测,采血取肾后家兔全部处死。E肝上平面结扎IVC组:14只,于上腹部取长约8cm切口,进入腹腔,于肝脏上及膈肌之间暴露出IVC后给予结扎,分别于术后1、3、5d采血检测肝功能,并取肝脏行病理检查。结果:B组术后各时间点血清肝、肾功与A组相应指标进行纵向比较,差别无统计学意义(P0.05),即假手术组对肝、肾功能无改变。C组家兔5天存活率71.42%,7天存活率42.86%,与正常家兔相比,肾功能改变表现为:血清Scr、Sur术后1天已升高,至术后3天达最高峰,后逐渐下降,至术后7天仍未降至正常;GFR术后1天已下降,至术后3天达最低谷,后逐渐升高,至术后7天仍未升至正常。D组家兔5天存活率85.71%,7天存活率71.42%,与正常家兔相比,肾功能改变趋势同C组,肾功能指标与C组纵向比较,差别有统计学意义(P0.05),即肾功能受损程度较C组轻,但至术后7天亦未恢复正常。E组术后1天肝功能指标明显升高,后呈上升趋势,术后1天死亡率为57.14%,术后3天死亡率85.71%,术后5天死亡率100%。结论:1.肾静脉平面以上结扎家兔IVC,因双肾静脉回流受阻而影响肾功能,若同时加用血栓通可一定程度保护肾功能。2.肝上平面结扎家兔IVC可使肝功能明显受损,预后差。
[Abstract]:Objective: To observe the changes of renal function and liver function at different time after ligating the inferior vene cava (IVC) on the renal vein and the upper plane of the renal vein and ligating the renal vein to IVC after IVC, so as to provide a theoretical basis for the surgical treatment of the inferior vena cava obstruction. Methods: 5 months of Japanese healthy large ear rabbits were selected from the animal experiment center of Zhengzhou University, body weight 2.0-2.3Kg, and male and female. The rabbits were randomly divided into five groups: A normal control group, 7 rats, serum creatinine (Scr), serum urea (Sur), glomerular rate filtration (GFR), alanine aminotransferase (ALT), aspartate aminotransferase (ASP) (AST), lactate dehydrogenase (LDH), and take the kidney, liver to do pathological examination. Blood collection, kidney, take the liver after the completion of the animal.B sham operation group: 28, the middle and upper abdomen to take a long about 10cm incision, into the abdominal cavity, after the exposure of IVC, the abdominal wall. After the operation of 1,3,5,7d heart blood sampling Scr, Sur, GFR, ALT, AST, LDH, and kidneys, The liver was preserved in the formalin solution. After collecting the blood and taking the kidney, all the rabbits were killed in the IVC group of.C simply ligating the renal vein: 28, open the abdominal cavity, expose the right renal vein and the IVC above the plane (the right renal vein of the rabbit is higher than the left renal vein), and ligate the IVC. The renal function was collected from the B group at each time point, and the renal function was detected and the rabbit after kidney was taken to take the kidney rabbit. All the patients were killed in the.D thrombus group: 28 rats, 3 days before the operation, the injection of intramuscular injection of thrombus, (Guangxi Wuzhou pharmaceutical Limited by Share Ltd production, batch number: Z20025652), the dose of 10mg/Kg body weight, 1 times a day. The operation method was with the group C, and the blood collection of the C group was examined, and the rabbit after the blood collection was all executed on the.E ligation of the liver, IVC ligation IVC Group: 14, taking a long 8cm incision in the upper abdomen, entering the abdominal cavity and exposing IVC between the liver and the diaphragm after exposure to the ligation. After the operation, the liver function was detected by 1,3,5d, and the liver was examined for pathological examination. Results: the liver was cleared at all time points in the group B, and the renal function was compared with the corresponding indexes of the A group in the longitudinal comparison, the difference was not statistically significant (P0.05). That is, the difference between the renal function and the A group was not statistically significant. The 5 day survival rate of the rabbits in the sham operation group and the renal function of the.C group was 71.42%, and the 7 day survival rate was 42.86%. Compared with the normal rabbit, the renal function changes were shown as: serum Scr, Sur increased at 1 days after operation, to 3 Tianda peak after operation, and then declined gradually, until the 7 day after the operation; 1 days after the operation, to 3 of the lowest valley of the postoperative 3 Tianda, after the operation of 3, after the operation, after the operation of 3, after the operation of 3 Tianda, after the post operation, after the 3 Tianda Valley, by the post by 3 Valley, after the post operation, after the 3 Tianda Valley, by the post by 3 Valley, after the post operation, after the lowest valley of Tianda, after the 3, after the operation, after the 3 Tianda, after the postoperative competition by 3 Tianda, after the chase after the operation 3, after the lowest valley by 3 Tianda after the operation, after the 3 Valley, after the post operation by 3 Tianda, after the chase after the operation of 3 Tianda after the operation, after the 3 Valley, after the post operation by the 3 Tianda, after the post operation by 3 Tianda, after the chase after the operation of 3, after the The 5 day survival rate of the rabbits in the normal.D group was 85.71% and the 7 day survival rate was 71.42%. Compared with the normal rabbit, the renal function change was compared with the C group, the renal function index was compared with the C group, and the difference was statistically significant (P0.05), that is, the degree of renal function damage was lighter than that in the C group, but the 5 day after the operation did not restore the liver 1 days after the operation of the normal group. The function index increased obviously and then increased, the mortality rate was 57.14% after 1 days after operation, the mortality rate was 85.71% at 3 days after operation, and the mortality rate of 5 days after operation was 100%. conclusion: 1. the rabbits were ligated above the renal vein plane, and the renal function was affected by the obstruction of the double renal vein reflux. If the renal function was added with thrombus at the same time, the renal function.2. in the upper hepatic plane could be ligated to a rabbit IVC. The liver function can be damaged obviously and the prognosis is poor.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R654.4

【相似文献】