囊肿去顶减压术是否改善肾功能的动物实验研究

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目的:通过模型加压兔子肾脏,监测加压前后肾功能变化,论证压力对肾功能的影响,根据实验结果给多囊肾临床治疗提供借鉴。方法:将成年新西兰兔随机分为三组(A,B,C),A组兔子切除一侧肾脏,另一侧肾脏通过模型固定圆形气泡予肾脏加压;B组兔子切除一侧肾脏,另一侧肾脏通过模型固定塑料圆球予肾脏加压;C组兔子切除一侧肾脏,另一侧肾脏不予加压处理。分别监测实验组和对照组兔子术前术后肾功的变化(血肌酐、尿素)。对不同加压肾脏标本进行HE、masson和六氨银染色,了解肾脏加压后的病理改变。结果:实验组A行加压术后肾功相对术前与对照组C相比无明显差异;实验组B行加压术后,肌酐、尿素升高明显,与术前、实验组A、对照组C比较均有明显差异(P<0.01)。实验组C一侧肾切除后相比术前肾功能无明显差异。病理示:肾脏加压后,肾小球、肾小管、肾血管继发一系列损害肾功的病理改变。结论:对肾脏施加的压力足够大的时候,压力致使肾脏发生相应病理改变,肌酐、尿素升高,肾功能明显下降。因此传统的囊肿去顶减压术,仍是有意义的对症治疗手段。 OBJECTIVE: To investigate the effect of pressure on renal function by monitoring the changes of renal function before and after compression in rabbits by the model, and to provide reference for the clinical treatment of polycystic kidney disease based on the experimental results. Methods: The adult New Zealand white rabbits were randomly divided into three groups (A, B, C). Rabbits in group A had one side of the kidney removed, and the other side of the kidney was pressurized by a fixed round bubble to the kidney. In group B, The other side of the kidney through the model fixed plastic balls to the kidney pressure; C group of rabbits removed one side of the kidney, the other side of the kidney without pressure treatment. The changes of renal function (serum creatinine, urea) before and after operation in rabbits in experimental group and control group were respectively monitored. Different pressurized kidney specimens were HE, masson and six ammonia silver staining to understand the pathological changes after kidney pressure. Results: There was no significant difference in renal function between group A and group C after operation in control group. After operation in group B, the creatinine and urea increased obviously in group B, which were significantly different from those in group A and control Group C were significantly different (P <0.01). There was no significant difference in preoperative renal function between experimental group C and nephrectomized. Pathology showed: kidney pressure, glomerular, tubular, renal vascular secondary to a series of pathological changes that impair renal function. CONCLUSIONS: When the pressure exerted on the kidneys is large enough, pressure causes a corresponding pathological change in the kidneys, with elevated creatinine and urea and markedly decreased renal function. Therefore, the traditional cyst decompression surgery is still a meaningful symptomatic treatment.
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