3M组织胶和电凝止血在尿毒症大鼠肾切除的应用
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摘要
目的对比两种止血方法在大鼠尿毒症模型的应用。方法雄性SD大鼠分为A、B两组,均采用左肾2/3切除加右肾切除制作尿毒症模型。A组左肾2/3切除时采用3M组织胶止血,B组采用电凝止血,术中比较出血量、左肾血流阻断时间,术后对比大鼠的存活率,测肌酐值,以达到正常血肌酐值2～3倍者为尿毒症大鼠模型。肾脏组织行病理检查。结果两种止血方法的血肌酐均升高达尿毒症模型要求;A组左肾血流阻断时间为(59.97±7.56) s,B组为(174.1±15.28) s(P<0.05);A组左肾切除的出血量为(0.11±0.037) mL,B组为(0.24±0.056) mL(P<0.05);两组肾组织病理学均提示肾小球缺血皱缩、小管间质纤维化;A组的术后存活率明显高于B组(P<0.05)。结论 3M组织胶无论是出血时间、出血量,还是术后存活率均优于电凝止血。
Objective To compare the effects of two hemostatic methods including 3 M vetbond tissue adhesive and electrocoagulation in a rat model of uremia.Methods Male SD rats were divided into groups A and B.To induce the uremia model,all rats underwent right and 2/3 left kidney resection.3 M vetbond tissue adhesive was used in the group A for hemostasis,while electric coagulation was used in group B.The amount of bleeding and the duration of left renal blood flow blockage during operation were assessed.The postoperative survival rates of the two groups were compared.The creatinine values of all rats after operation were measured,and rats for which the creatinine value was two to three times higher than normal were further regarded as a uremic model.Kidney tissues were examined by pathology.Results The serum creatinine after the application of both hemostatic method after 5/6 renal resection was 2-3 times higher than the normal level.Left renal blood flow blockage of group A was(59.97 ±7.56) s and that of group B was(174.1±15.28) s(P<0.05).The blood loss of the group A during left renal resection was(0.11±0.037) mL,and that of group B was(0.24 ±0.056) mL(P< 0.05).Pathology of renal tissues in both groups indicated glomerular ischemic shrinkage and tubular interstitial fibrosis.The postoperative survival rate of group A was significantly higher than that of the group B(P<0.05).Conclusions 3 M vetbond tissue adhesive is more effective than electrocoagulation to shorten the bleeding time,decrease the bleeding amount,or increase the postoperative survival rate.
Objective To compare the effects of two hemostatic methods including 3 M vetbond tissue adhesive and electrocoagulation in a rat model of uremia.Methods Male SD rats were divided into groups A and B.To induce the uremia model,all rats underwent right and 2/3 left kidney resection.3 M vetbond tissue adhesive was used in the group A for hemostasis,while electric coagulation was used in group B.The amount of bleeding and the duration of left renal blood flow blockage during operation were assessed.The postoperative survival rates of the two groups were compared.The creatinine values of all rats after operation were measured,and rats for which the creatinine value was two to three times higher than normal were further regarded as a uremic model.Kidney tissues were examined by pathology.Results The serum creatinine after the application of both hemostatic method after 5/6 renal resection was 2-3 times higher than the normal level.Left renal blood flow blockage of group A was(59.97 ±7.56) s and that of group B was(174.1±15.28) s(P<0.05).The blood loss of the group A during left renal resection was(0.11±0.037) mL,and that of group B was(0.24 ±0.056) mL(P< 0.05).Pathology of renal tissues in both groups indicated glomerular ischemic shrinkage and tubular interstitial fibrosis.The postoperative survival rate of group A was significantly higher than that of the group B(P<0.05).Conclusions 3 M vetbond tissue adhesive is more effective than electrocoagulation to shorten the bleeding time,decrease the bleeding amount,or increase the postoperative survival rate.
引文
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[18]卜文,李彦,郎书惠,等.大鼠体内大脏器创伤模型涂布康派特医用胶后生物反应观测[J].医疗装备,2015(7):21-29.
[19]王养忠,朱豫,周丽君,等.EC耳脑胶在眶壁修复术中应用[J].中国实用眼科杂志,2004,22(5):400.
[20]张宜,喻晶,曹利利,等.基于止血药研究的兔止血模型概述[J].华南国防医学杂志,2015,29(7):560-562.
[21]Romero IL,Malta JB,Silva CB,et al.Antibacterial properties of cyanoacrylate tissue adhesive:Does the polymerization reaction play a role?[J].Indian J Ophthalmol,2009,57(5):341-344.
[22]Gonzalez E,Orta J,Quero C,et al.Ethyl 2 cyanoacrylate fixation of the cranial bone flap after craniotomy[J].Surg Neurol,2000,53(3):288-289.
[23]Yao J,Zhang Y,Hu Q,et al.Optimization of paeonol-loaded poly(butyl-2-cyanoacrylate)nanocapsules by central composite design with response surface methodology together with the antibacterial properties[J].Eur J Pharm Sci,2017,101:189-199.
[24]李红艳.大鼠慢性肾功能不全模型两种制作方式的比较[J].中国实验动物学报,2008,16(1):59-61.
[2]Xie Y,Bowe B,Mokdad AH,et al.Analysis of the Global Burden of Disease study highlights the global,regional,and national trends of chronic kidney disease epidemiology from 1990to 2016[J].Kidney Int,2018,94(3),567-581.
[3]肖炜,马云,傅江南.慢性肾衰动物模型方法学研究现状[J].中国比较医学杂志,2002,12(3):176-179.
[4]李传贵,宋亚军,宋波,等.生物胶及缝扎法对兔肾创伤治疗效果的实验研究[J].第三军医大学学报,2015,37(23):2364-2367.
[5]李东红,高华,李鹏熙,等.几种止血材料对兔实质脏器创伤止血性能的比较[J].创伤外科杂志,2012(5):435-438.
[6]Ferrantelli E,Liappas G,Keuning ED,et al.A novel mouse model of peritoneal dialysis:combination of uraemia and longterm exposure to PD fluid[J].BioMed Res Int,2015,2015:106902.
[7]Zareie M,De Vriese AS,Hekking LH,et al.Immunopathological changes in a uraemic rat model for peritoneal dialysis[J].Nephrol Dial Transplant,2005,20(7):1350-1361.
[8]Kull S,Martinelli I,Briganti E,et al.Glubran2 surgical glue:in vitro evaluation of adhesive and mechanical properties[J].JSurg Res,2009,157(1):e15-21.
[9]李传贵,宋波,郑宗钊,等.生物胶对兔肾脏创伤出血治疗效果的研究[J].重庆医学,2015,44(6):743-745.
[10]Schneider G,Otto K.In vitro and in vivo studies on the use of Histoacrylas a soft tissue glue[J].Eur Arch Otorhinolaryngol,2012,269(7):1783-1789.
[11]Boersema GSA,Vennix S,Wu Z,et al.Reinforcement of the colon anastomosis with cyanoacrylate glue:a porcine model[J].JSurg Res,2017,217:84-91.
[12]Park YH,Chang AS,Choi GW,et al.A comparison of three methods of skin closure following repair of Achilles tendon rupture[J].Injury,2018,49(10):1942-1946.
[13]戈静,王清.两种止血法对腹腔镜卵巢囊肿剥除术卵巢储备功能的影响[J].实用心脑肺血管病杂志,2012,31(9):77-80.
[14]倪加凤,栾翠芳.超声切割止血刀的手术室维护与保养[J].腹腔镜外科杂志,2010,15(7):541-541.
[15]Espin Alvarez F,Rodriguez Rivero AM,Navines Lopez J,et al.Clinical feasibility of large gastrotomy closure using a flexible tissue glue based on N-Butyl-2-Cyanoacrylate:experimental study in pigs[J].J Gastrointest Surg,2019,23(2):247-255.
[16]吴斌,张峰.单极电凝免缝合技术在腹腔镜肾部分切除术中初步应用[J].中华医学杂志,2016,96(48):3885.
[17]Sultan A,Mohamed A.Efficacy and safety of using n-butyl cyanoacrylate in cranial fixation following trauma and other pathologies[J].Turk Neurosurg,2018,28(3):416-420.
[18]卜文,李彦,郎书惠,等.大鼠体内大脏器创伤模型涂布康派特医用胶后生物反应观测[J].医疗装备,2015(7):21-29.
[19]王养忠,朱豫,周丽君,等.EC耳脑胶在眶壁修复术中应用[J].中国实用眼科杂志,2004,22(5):400.
[20]张宜,喻晶,曹利利,等.基于止血药研究的兔止血模型概述[J].华南国防医学杂志,2015,29(7):560-562.
[21]Romero IL,Malta JB,Silva CB,et al.Antibacterial properties of cyanoacrylate tissue adhesive:Does the polymerization reaction play a role?[J].Indian J Ophthalmol,2009,57(5):341-344.
[22]Gonzalez E,Orta J,Quero C,et al.Ethyl 2 cyanoacrylate fixation of the cranial bone flap after craniotomy[J].Surg Neurol,2000,53(3):288-289.
[23]Yao J,Zhang Y,Hu Q,et al.Optimization of paeonol-loaded poly(butyl-2-cyanoacrylate)nanocapsules by central composite design with response surface methodology together with the antibacterial properties[J].Eur J Pharm Sci,2017,101:189-199.
[24]李红艳.大鼠慢性肾功能不全模型两种制作方式的比较[J].中国实验动物学报,2008,16(1):59-61.