本文關(guān)鍵詞： 犬腎盂積水 腎臟摘除療法 血常規(guī)與生化指標 B超形態(tài)變化 組織變化　出處：《南京農(nóng)業(yè)大學》2015年碩士論文　論文類型：學位論文

【摘要】：腎盂積水是目前小動物臨床的常見疾病之一,其病因是尿路發(fā)生阻塞,根據(jù)發(fā)生阻塞的部位和程度不同,有不同的治療方法�；紓�(cè)腎臟摘除法適用于單側(cè)腎臟發(fā)生腎盂積水的治療。據(jù)文獻報道,單側(cè)腎臟發(fā)生梗阻而致腎盂積水時,對側(cè)腎臟會代償性生長,有學者研究發(fā)現(xiàn),代償腎臟在代償性生長的過程中受到患側(cè)腎臟的影響,會發(fā)生細胞凋亡并受到一定損害,且這種傷害與腎盂積水發(fā)生的時間及阻塞程度有關(guān)。本試驗主要探究使用腎臟摘除法治療單側(cè)腎盂積水時,進行手術(shù)的時機對犬及其健側(cè)腎臟的代償生長是否有影響。為臨床上使用單側(cè)腎臟摘除法治療犬腎臟積水提供參考依據(jù)。試驗Ⅰ、犬腎盂積水模型的建立為了研究犬發(fā)生腎盂積水使用去腎治療法對犬的影響,首先應建立犬腎盂積水的模型。方法:對試驗犬進行健康檢查以確定試驗犬的健康狀況都良好后,將9只試驗犬隨機分為3組。對每只試驗犬進行手術(shù),結(jié)扎左側(cè)輸尿管。輸尿管阻塞后導致左側(cè)腎臟腎盂積水,以B超檢查觀察腎盂積水的情況。結(jié)果:輸尿管結(jié)扎后,腎臟發(fā)生腎盂積水,B超檢查可見腎臟體積增大,輸尿管管徑增大。犬腎盂積水模型建立成功。試驗Ⅱ、腎臟摘除術(shù)治療犬單側(cè)腎盂積水對犬血常規(guī)及生化指標的影響研究腎盂積水發(fā)生后不同時間點摘除患腎后對犬血常規(guī)及生化指標的影響。方法:選取9只健康成年中華田園犬,將其分為A、B、C三組,每組3只。對9只犬全部進行左側(cè)輸尿管結(jié)扎。于結(jié)扎后1周、2周、4周后,分別對A、B、C三組試驗犬進行左側(cè)腎臟摘除術(shù)。分別于腎臟摘除手術(shù)前一天,手術(shù)后第1、2、3、4、7、14、28、42天采集試驗犬血液,檢測血常規(guī)和生化指標。結(jié)果:腎盂積水發(fā)生后不同時間點摘除患腎后,犬的大部分血常規(guī)指標變化無明顯差異,僅白細胞和粒細胞在后期出現(xiàn)顯著差異性。血清肌酐和尿素氮都呈逐漸上升的趨勢,在28天后各組差異顯著。血清磷濃度呈上升趨勢,各天三組的數(shù)據(jù)相比無明顯差異。由此可見,腎臟摘除術(shù)治療犬單側(cè)腎盂積水是可行的,且施行手術(shù)的時間越晚,對犬血常規(guī)及生化指標的影響越大。試驗Ⅲ、腎臟摘除術(shù)治療犬單側(cè)腎盂積水對犬代償腎臟構(gòu)型變化的影響研究腎盂積水不同時間后摘除患腎,對健側(cè)腎臟形態(tài)結(jié)構(gòu)的影響。方法:選取9只健康成年中華田園犬,隨機分為A、B、C三個組,每組3只。對每只犬進行左側(cè)輸尿管結(jié)扎手術(shù)。在輸尿管結(jié)扎術(shù)后的第1、2、4周,分別對A、B、C組犬進行左側(cè)腎臟摘除術(shù)。在各組試驗犬進行腎臟摘除術(shù)前1天,術(shù)后第1、2、3、4、7、14、28、42天,分別對A、B、C組的試驗犬進行右腎B超檢查,記錄右腎長、腎寬及腎皮質(zhì)厚度。結(jié)果:腎臟摘除后42天,A、B組的代償腎臟腎長分別較手術(shù)前增大了 9.85%和4.12%,而C組較術(shù)前減小了 1.73%,A、B組腎寬分別增大了 16.99%,6.79%,而C組減小了 2.14%。腎臟皮質(zhì)的變化不大,手術(shù)后第42天與手術(shù)前相比,A、B組僅分別增大了 0.61%、0.62%,C組無變化。由上可知,腎臟摘除術(shù)治療犬單側(cè)腎盂積水時,患側(cè)腎臟在體內(nèi)的留存時間對腎臟B超形態(tài)影響不顯著。試驗Ⅳ、腎臟摘除術(shù)治療犬腎盂積水對單側(cè)犬代償腎臟組織學變化的影響腎盂積水發(fā)生后不同時間后摘除腎臟,犬代償腎臟會發(fā)生組織學的變化,通過研究代償腎臟組織學的變化來觀察摘除腎臟手術(shù)對犬的影響。方法:選取9只健康成年中華田園犬,隨機分為A、B、C三個組,每組3只。對每只犬進行左側(cè)輸尿管結(jié)扎手術(shù)。在輸尿管結(jié)扎術(shù)后的第1、2、4周,分別對A、B、C組犬進行左側(cè)腎臟摘除術(shù)。在腎臟摘除術(shù)后第42天后,采集代償腎(右腎)組織,樣品置于4%%甲醛溶液中固定,4℃保存,并對其進行常規(guī)組織病理學檢查。結(jié)果:A組犬右腎腎小球形態(tài)完整,體積無明顯變化,沒有明顯分葉,腎小管上皮輕微水腫,未見有上皮細胞脫落,腎間質(zhì)無明顯變化。B組犬右腎腎小球體積輕微增大,腎小球囊腔變小,血管球略有分葉,腎小管上皮水腫,部分脫落,管腔擴張。腎間質(zhì)水腫,蛋白管型。C組犬右腎組織可見部分腎小球充血,體積減小,分葉明顯,系膜細胞增生,球囊間隙增大。腎小管上皮變性壞死,在管腔內(nèi)可見脫落的上皮細胞,可見部分出現(xiàn)蛋白管型,腎間質(zhì)炎性浸潤。由此可知,腎臟摘除術(shù)治療犬單側(cè)腎盂積水時,患側(cè)腎臟在體內(nèi)的留存時間越長對腎臟組織影響越大。
[Abstract]:Hydronephrosis is a common disease of the small animal clinic at present, the etiology of urinary tract obstruction is occurred, according to the location and degree of obstruction, with different treatment methods. The ipsilateral kidney removal method is suitable for treating unilateral kidney hydronephrosis. It is reported that the single side kidney obstruction with hydronephrosis. The contralateral kidney will compensatory growth, some scholars have found that the compensatory kidney by affected kidneys during compensatory growth, apoptosis will occur and damage, and the damage time and degree of obstruction and hydronephrosis occurred. This experiment mainly explore the use of kidney removal to treat unilateral hydronephrosis when does the operation time have effect on dogs and contralateral kidney compensatory growth. For the clinical use of unilateral renal extraction treatment of canine kidney seeper provide reference. In Experiment I, canine hydronephrosis model in order to study the occurrence of canine hydronephrosis using renal therapy effect on dog, should first establish a canine hydronephrosis model. Methods: health examination of test dogs to determine test dogs have a good health condition, 9 experimental dogs were randomly divided into 3 groups. Operation of each canine, ligation of the left ureter. Ureteral obstruction after left renal hydronephrosis, hydronephrosis by ultrasound observation. Results: ureteral ligation, kidney hydronephrosis, ultrasound examination showed kidney volume increased, ureter diameter increases. Hydronephrosis canine model was established successfully. The test of the kidney study on removal of hydronephrosis operation treatment of unilateral hydronephrosis on canine blood routine and biochemical indexes of different time points after removal effect on canine blood routine and biochemical indexes of kidney. Methods: 9 healthy adult dogs Chinese garden, which is divided into A, B, C three groups, 3 rats in each group. All were left ureteral ligation in 9 dogs. After ligation of 1 weeks, 2 weeks, 4 weeks, respectively A, B, C three groups of experimental dogs left kidney resection in the removal of kidney. The day before operation, postoperative day 1,2,3,4,7,14,28,42 of canine blood collection, blood routine and biochemical indexes. Results: hydronephrosis occurs at different time points after removal of the kidney, no significant difference between the change of blood routine index of most dogs, only white blood cells and granulocytes appeared significant difference in serum in later stage. Creatinine and urea nitrogen were increased gradually in 28 days, significant differences between each group. Serum phosphorus concentration increased, there was no significant difference between the three day group data. Thus, the renal resection treatment of unilateral hydronephrosis is feasible, and the implementation of the operation of the late time, the 鐘甯歌鍙婄敓鍖栨寚鏍囩殑褰卞搷瓚婂ぇ.璇曢獙鈪，

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