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目的:建立一种肾镜下肾盂灌注冲洗并发全身炎症反应综合征(SIRS)的猪模型。方法:家猪10头,随机分为假手术组和模型组,每组按时间点分为基础状态(Basic)、术后0h、术后6h、术后12h和术后24h 5个亚组。猪肾穿刺造瘘,利用自体盲肠内容物加入肾盂冲洗液中,模拟经皮肾镜取石术(PCNL)持续肾盂灌注冲洗1h。每个时间点观测肛温(T)、呼吸(RR)、心率(HR);采血行血细胞计数分析(WBC、RBC、PLT)、肾功能(Cr、BUN、β2-MG)测定、血清IL-6、IL-10、TNF-α含量测定;用光镜和电镜观察肾脏组织病理变化。结果:模型组在术后6 h-24 h各项指标与假手术组相比变化明显,差异有统计学意义(P<0.05或<0.01)。模型组肾脏组织光镜和电镜下观察病理切片均较假手术组有明显的形态学改变。结论:本模型较好地模拟了临床病人PCNL并发SIRS的病理生理过程,为进一步研究其发病机制和预防治疗具有重要意义。
OBJECTIVE: To establish a porcine model of renal pyelonephritis with systemic inflammatory response syndrome (SIRS). Methods: 10 domestic pigs were randomly divided into sham-operation group and model group. Each group was divided into basic group, 0h after operation, 6h after operation, 12h after operation and 5h after operation. Porcine renal puncture fistula, the use of the contents of the autologous cecal fill fluid rinse, simulated percutaneous nephrolithotomy (PCNL) continuous renal perfusion irrigation 1h. The rectal temperature, respiration rate and heart rate were measured at each time point. Blood count (WBC, RBC, PLT), renal function (Cr, BUN and β2-MG) 6, IL-10 and TNF-α were measured. The histopathological changes of kidney were observed by light microscope and electron microscope. Results: Compared with the sham group, the indexes of the model group at 6 h-24 h after operation changed significantly (P <0.05 or <0.01). In the model group, the morphological changes of kidney tissue and electron microscope were observed. Conclusion: This model better simulates the pathophysiology of PCNL complicated with SIRS in clinical patients, which is of great significance for further study of its pathogenesis and prevention and treatment.