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-  2017 

气腹压对不同程度积水肾的损伤作用 Kidney Injury Caused by Pneumoperitoneum Pressure in Various Degrees of Kidney Hydronephrosis

Keywords: 肾积水,二氧化碳,气腹压,损伤

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Abstract:

目的:研究不同大小的气腹压力对于不同程度的积水肾的损伤作用。方法:采用输尿管套扎法建立左侧轻、重度肾积水模型,54只新西兰大白兔随机分为三组:假手术组(N组,n=18),轻度积水组(M组,n=18),重度积水组(S组,n=18),每组再分为三个亚组,依次给予0,10,15mmHg气腹加压处理1h。术后48h取左侧肾脏,HE染色观察肾小管形态结构,测肾组织内活性氧(ROS),丙二醛(MDA),乳酸(LD)含量,TUNEL检测细胞凋亡,取血清检测血肌酐(Cr),尿素氮(BUN)。结果:对于假手术组和轻度积水组,当压力为15mmHg时,肾损伤明显加重(肾小管结构明显改变,凋亡指数明显增加,ROS,MDA,LD含量明显升高);对于重度积水组,当压力为10mmHg时,肾脏损伤即明显加重。各小组Cr及BUN的差异无统计学意义。结论:重度积水的肾脏更容易受到气腹压造成的进一步损伤,行腹腔镜手术时应适当控制气腹压的大小

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