高原环境下野战机动式连续性血液净化系统对急性肾衰竭犬治疗的实验研究

发布时间：2018-12-21 20:34

【摘要】：目的建立犬急性肾衰竭(ARF)模型,观察野战机动式连续性血液净化系统在高原环境(海拔3640m)下工作的稳定性、有效性及安全性。方法选择成年比格犬,外科行双肾切除术制作致ARF模型,应用野战机动式连续性血液净化机行持续静-静脉血液滤过治疗。应用自身对照方法观察治疗前后动物模型生命体征、肝功能、肾功能及血清离子水平变化。检测高原环境下野战机动式连续性血液净化系统的工作性能。结果 6只犬术后24h血尿素氮(BUN)、肌酐(Cr)升高,与术前比较差异有统计学意义(P0.05),符合ARF诊断标准。3只犬行颈外静脉血液透析用双腔静脉导管置管,3只犬行股静脉置管;5只犬完成全部实验,1只犬因透析管脱落,失血死亡。与治疗前比较,ARF犬治疗后2、4h,平均动脉压、心率、呼吸频率与治疗前比较差异无统计学意义(P0.05)。血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)及总胆红素(T-Bil)水平与治疗前比较差异无统计学意义(P0.05)。血清BUN及Cr水平较治疗前下降,差异有统计学意义(P0.05)。血清K+水平下降,与治疗前比较差异有统计学意义(P0.05)。治疗过程中无出血、过敏、低血压等并发症发生。野战机动式连续性血液净化系统对异常情况反应敏感、报警迅速。治疗前后系统设置与实际测得的置换液、废液量误差分别为0.273%±0.015%、0.182%±0.014%,差异无统计学意义(P0.05),符合国家行业标准。结论高原环境下野战机动式连续性血液净化系统工作性能稳定,对ARF治疗安全、有效。
[Abstract]:Objective to establish a canine (ARF) model of acute renal failure (ARF) and to observe the stability, efficacy and safety of continuous field mobile blood purification system working at high altitude (3640m). Methods the ARF model was made by bilateral nephrectomy in adult Beagle dogs, and continuous venovenous hemofiltration was performed with field maneuvering continuous blood purification machine. The changes of vital signs, liver function, renal function and serum ion levels were observed before and after treatment. The working performance of mobile continuous blood purification system in high altitude environment was tested. Results the blood urea nitrogen (BUN),) creatinine (Cr) increased 24 hours after operation in 6 dogs, which was significantly higher than that before operation (P0.05), which was in accordance with the diagnostic criteria of ARF. 3 dogs underwent external jugular vein hemodialysis with double vena cava catheters. 3 dogs underwent femoral vein catheterization. All the experiments were completed in 5 dogs. One dog died of blood loss due to dialysis tube falling off. Compared with before treatment, the mean arterial pressure, heart rate and respiratory frequency of ARF dogs were not significantly different from those before treatment (P0.05). The levels of serum alanine aminotransferase (ALT),) aspartate transaminase (AST) and total bilirubin (T-Bil) were not significantly different from those before treatment (P0.05). The levels of serum BUN and Cr were significantly lower than those before treatment (P0.05). Serum K level decreased, compared with the treatment before the difference was statistically significant (P0.05). No bleeding, hypersensitivity, hypotension and other complications occurred during the treatment. The field maneuvering continuous blood purification system is sensitive to abnormal situations and alarm is rapid. Before and after treatment, the system setup and the actual measurement of the displacement liquid, the amount of waste liquid error was 0.273% 卤0.015% 卤0.014%, the difference was not statistically significant (P0.05), in line with the national industry standards. Conclusion the field mobile continuous blood purification system has stable working performance and is safe and effective in the treatment of ARF at high altitude.
【作者单位】：解放军309医院器官移植研究所;北京奥佳盛康科技发展有限公司;
【基金】：北京市科技专项2011阶梯计划项目(Z111102055311086)~~
【分类号】：R82

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