本文選題：IVC + 腎靜脈上��； 參考：《鄭州大學(xué)》2016年碩士論文

【摘要】：目的:本研究通過(guò)在腎靜脈上及肝上平面結(jié)扎家兔下腔靜脈(inferior vene cava,IVC),并于腎靜脈上結(jié)扎IVC后使用血栓通藥物,觀察術(shù)后不同時(shí)間腎、肝功能指標(biāo)改變及病理學(xué)改變規(guī)律,以期為下腔靜脈阻塞性疾病的外科治療提供理論依據(jù)。方法:選取5個(gè)月日本健康大耳兔,由鄭州大學(xué)動(dòng)物實(shí)驗(yàn)中心提供,體重2.0-2.3Kg,雌雄不限。將家兔隨機(jī)分為五組:A正常對(duì)照組:7只,心臟采血后檢測(cè)血清肌酐(Scr)、血清尿素(Sur)、腎小球率過(guò)濾(GFR)、丙氨酸氨基轉(zhuǎn)移酶(ALT)、天冬氨酸氨基轉(zhuǎn)移酶(AST),乳酸脫氫酶(LDH),并取腎臟、肝臟做病理組織檢查。采血、取腎、取肝完成后處死動(dòng)物。B假手術(shù)組:28只,于中上腹部取長(zhǎng)約10cm手術(shù)切口,進(jìn)入腹腔,暴露出IVC后即逐層關(guān)閉腹壁。分別于術(shù)后1、3、5、7d心臟采血檢測(cè)Scr、Sur、GFR、ALT、AST、LDH,并取腎臟、肝臟放置于福爾馬林溶液中保存。采血取腎后,家兔全部處死。C單純結(jié)扎腎靜脈上IVC組:28只,打開(kāi)腹腔,暴露右腎靜脈及其平面以上IVC(家兔右腎靜脈高于左腎靜脈),結(jié)扎IVC,分別同B組于每個(gè)時(shí)間點(diǎn)取7只家兔,采血檢測(cè)腎功能,取腎后家兔全部處死。D血栓通治療組:28只,術(shù)前3天開(kāi)始肌肉注射血栓通注射液,(廣西梧州制藥股份有限公司生產(chǎn),批號(hào):Z20025652),劑量為10mg/Kg體重,每天注射1次。手術(shù)方法同C組,并同C組采血取腎進(jìn)行檢測(cè),采血取腎后家兔全部處死。E肝上平面結(jié)扎IVC組:14只,于上腹部取長(zhǎng)約8cm切口,進(jìn)入腹腔,于肝臟上及膈肌之間暴露出IVC后給予結(jié)扎,分別于術(shù)后1、3、5d采血檢測(cè)肝功能,并取肝臟行病理檢查。結(jié)果:B組術(shù)后各時(shí)間點(diǎn)血清肝、腎功與A組相應(yīng)指標(biāo)進(jìn)行縱向比較,差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),即假手術(shù)組對(duì)肝、腎功能無(wú)改變。C組家兔5天存活率71.42%,7天存活率42.86%,與正常家兔相比,腎功能改變表現(xiàn)為:血清Scr、Sur術(shù)后1天已升高,至術(shù)后3天達(dá)最高峰,后逐漸下降,至術(shù)后7天仍未降至正常;GFR術(shù)后1天已下降,至術(shù)后3天達(dá)最低谷,后逐漸升高,至術(shù)后7天仍未升至正常。D組家兔5天存活率85.71%,7天存活率71.42%,與正常家兔相比,腎功能改變趨勢(shì)同C組,腎功能指標(biāo)與C組縱向比較,差別有統(tǒng)計(jì)學(xué)意義(P0.05),即腎功能受損程度較C組輕,但至術(shù)后7天亦未恢復(fù)正常。E組術(shù)后1天肝功能指標(biāo)明顯升高,后呈上升趨勢(shì),術(shù)后1天死亡率為57.14%,術(shù)后3天死亡率85.71%,術(shù)后5天死亡率100%。結(jié)論:1.腎靜脈平面以上結(jié)扎家兔IVC,因雙腎靜脈回流受阻而影響腎功能,若同時(shí)加用血栓通可一定程度保護(hù)腎功能。2.肝上平面結(jié)扎家兔IVC可使肝功能明顯受損,預(yù)后差。
[Abstract]:Objective: To observe the changes of renal function and liver function at different time after ligating the inferior vene cava (IVC) on the renal vein and the upper plane of the renal vein and ligating the renal vein to IVC after IVC, so as to provide a theoretical basis for the surgical treatment of the inferior vena cava obstruction. Methods: 5 months of Japanese healthy large ear rabbits were selected from the animal experiment center of Zhengzhou University, body weight 2.0-2.3Kg, and male and female. The rabbits were randomly divided into five groups: A normal control group, 7 rats, serum creatinine (Scr), serum urea (Sur), glomerular rate filtration (GFR), alanine aminotransferase (ALT), aspartate aminotransferase (ASP) (AST), lactate dehydrogenase (LDH), and take the kidney, liver to do pathological examination. Blood collection, kidney, take the liver after the completion of the animal.B sham operation group: 28, the middle and upper abdomen to take a long about 10cm incision, into the abdominal cavity, after the exposure of IVC, the abdominal wall. After the operation of 1,3,5,7d heart blood sampling Scr, Sur, GFR, ALT, AST, LDH, and kidneys, The liver was preserved in the formalin solution. After collecting the blood and taking the kidney, all the rabbits were killed in the IVC group of.C simply ligating the renal vein: 28, open the abdominal cavity, expose the right renal vein and the IVC above the plane (the right renal vein of the rabbit is higher than the left renal vein), and ligate the IVC. The renal function was collected from the B group at each time point, and the renal function was detected and the rabbit after kidney was taken to take the kidney rabbit. All the patients were killed in the.D thrombus group: 28 rats, 3 days before the operation, the injection of intramuscular injection of thrombus, (Guangxi Wuzhou pharmaceutical Limited by Share Ltd production, batch number: Z20025652), the dose of 10mg/Kg body weight, 1 times a day. The operation method was with the group C, and the blood collection of the C group was examined, and the rabbit after the blood collection was all executed on the.E ligation of the liver, IVC ligation IVC Group: 14, taking a long 8cm incision in the upper abdomen, entering the abdominal cavity and exposing IVC between the liver and the diaphragm after exposure to the ligation. After the operation, the liver function was detected by 1,3,5d, and the liver was examined for pathological examination. Results: the liver was cleared at all time points in the group B, and the renal function was compared with the corresponding indexes of the A group in the longitudinal comparison, the difference was not statistically significant (P0.05). That is, the difference between the renal function and the A group was not statistically significant. The 5 day survival rate of the rabbits in the sham operation group and the renal function of the.C group was 71.42%, and the 7 day survival rate was 42.86%. Compared with the normal rabbit, the renal function changes were shown as: serum Scr, Sur increased at 1 days after operation, to 3 Tianda peak after operation, and then declined gradually, until the 7 day after the operation; 1 days after the operation, to 3 of the lowest valley of the postoperative 3 Tianda, after the operation of 3, after the operation, after the operation of 3, after the operation of 3 Tianda, after the post operation, after the 3 Tianda Valley, by the post by 3 Valley, after the post operation, after the 3 Tianda Valley, by the post by 3 Valley, after the post operation, after the lowest valley of Tianda, after the 3, after the operation, after the 3 Tianda, after the postoperative competition by 3 Tianda, after the chase after the operation 3, after the lowest valley by 3 Tianda after the operation, after the 3 Valley, after the post operation by 3 Tianda, after the chase after the operation of 3 Tianda after the operation, after the 3 Valley, after the post operation by the 3 Tianda, after the post operation by 3 Tianda, after the chase after the operation of 3, after the The 5 day survival rate of the rabbits in the normal.D group was 85.71% and the 7 day survival rate was 71.42%. Compared with the normal rabbit, the renal function change was compared with the C group, the renal function index was compared with the C group, and the difference was statistically significant (P0.05), that is, the degree of renal function damage was lighter than that in the C group, but the 5 day after the operation did not restore the liver 1 days after the operation of the normal group. The function index increased obviously and then increased, the mortality rate was 57.14% after 1 days after operation, the mortality rate was 85.71% at 3 days after operation, and the mortality rate of 5 days after operation was 100%. conclusion: 1. the rabbits were ligated above the renal vein plane, and the renal function was affected by the obstruction of the double renal vein reflux. If the renal function was added with thrombus at the same time, the renal function.2. in the upper hepatic plane could be ligated to a rabbit IVC. The liver function can be damaged obviously and the prognosis is poor.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R654.4

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 鄒進(jìn);血栓通治療椎—基底動(dòng)脈供血不足16例[J];現(xiàn)代醫(yī)藥衛(wèi)生;2002年06期

2 徐紅霞;血栓通治療椎基底動(dòng)脈供血不足的療效觀察[J];實(shí)用神經(jīng)疾病雜志;2005年03期

3 龐紹睿,王淑娟;血栓通治療急性缺血性腦血管病32例[J];菏澤醫(yī)學(xué)�？茖W(xué)校學(xué)報(bào);2005年01期

4 劉艷英;;血栓通治療54例難治性腎病綜合癥的效果觀察[J];中醫(yī)臨床研究;2011年24期

5 黃宇;;不同劑量血栓通對(duì)短暫性腦缺血發(fā)作的療效[J];中國(guó)實(shí)用神經(jīng)疾病雜志;2014年11期

6 王慧敏;血栓通治療老年人短暫性腦缺血發(fā)作32例[J];時(shí)珍國(guó)醫(yī)國(guó)藥;2001年11期

7 王丙龍,張偉杰;血栓通治療下肢動(dòng)脈硬化閉塞癥58例臨床觀察[J];實(shí)用醫(yī)技雜志;2003年02期

8 王丙龍;血栓通治療下肢閉塞性動(dòng)脈硬化癥療效分析[J];中國(guó)中西醫(yī)結(jié)合外科雜志;2003年05期

9 張婭東;朱鳳元;田建華;鄭華春;;2型糖尿病患者血栓通治療前后血栓狀態(tài)變化[J];基層醫(yī)學(xué)論壇;2003年08期

10 矯音華;丹參、血栓通輔助治療2型糖尿病臨床觀察[J];社區(qū)醫(yī)學(xué)雜志;2004年04期

相關(guān)會(huì)議論文 前7條

1 杜金行;史載祥;黃力;張久亮;任在方;毛建生;曹啟富;李格;李春巖;;血栓通抗凝溶栓治療急性腦梗死的臨床研究[A];第五次全國(guó)中西醫(yī)結(jié)合血瘀證及活血化瘀研究學(xué)術(shù)大會(huì)論文匯編[C];2001年

2 陸暉;曾祥發(fā);蔣祁桂;;血栓通對(duì)腦缺血再灌注損傷大鼠神經(jīng)細(xì)胞熱休克蛋白70表達(dá)的影響[A];第三屆全國(guó)少數(shù)民族地區(qū)神經(jīng)病學(xué)會(huì)論文匯編[C];2005年

3 裘昊;袁明;;血栓通(粉)針治療腦梗死的臨床觀察[A];浙江省中西醫(yī)結(jié)合學(xué)會(huì)神經(jīng)內(nèi)科專業(yè)委員會(huì)第六次學(xué)術(shù)年會(huì)暨國(guó)家級(jí)繼續(xù)教育學(xué)習(xí)班資料匯編[C];2008年

4 李新軍;;中藥血栓通針劑在眼外傷的應(yīng)用(附20例球內(nèi)出血治療報(bào)告)[A];全國(guó)首屆中青年中醫(yī)眼科學(xué)術(shù)研討會(huì)資料匯編[C];1996年

5 陳鳳霞;張艷芳;杜健茹;;血栓通直流電導(dǎo)入治療眼底血管性和出血性疾病80例[A];中國(guó)康復(fù)醫(yī)學(xué)會(huì)第二屆全國(guó)康復(fù)治療學(xué)術(shù)會(huì)議論文匯編[C];1999年

6 高春蘭;張?chǎng)?鄭白蘭;;注射用血栓通聯(lián)合復(fù)方樟柳堿在治療前部缺血性視神經(jīng)病變的療效分析[A];2013年中國(guó)藥學(xué)大會(huì)暨第十三屆中國(guó)藥師周論文集[C];2013年

7 王潤(rùn)理;;聯(lián)合血栓通治療腦出血的臨床觀察[A];山東省第三次中西醫(yī)結(jié)合神經(jīng)內(nèi)科學(xué)術(shù)研討會(huì)論文匯編[C];2011年

相關(guān)重要報(bào)紙文章 前8條

1 吳文;啟動(dòng)血栓通注射劑深度研究與質(zhì)量提升工程[N];中國(guó)醫(yī)藥報(bào);2011年

2 實(shí)習(xí)記者 董紅燕 本報(bào)記者 楊俊堅(jiān);血栓通擴(kuò)產(chǎn)能為增長(zhǎng)筑底[N];醫(yī)藥經(jīng)濟(jì)報(bào);2013年

3 新訊;血栓可能是癌癥前兆[N];醫(yī)藥經(jīng)濟(jì)報(bào);2003年

4 本報(bào)記者 黃華祿;專利在手,權(quán)益才有[N];中國(guó)知識(shí)產(chǎn)權(quán)報(bào);2014年

5 本報(bào)記者 姜瑩瑩;豚鼠試驗(yàn)找到病毒性耳聾克星[N];北京科技報(bào);2006年

6 廣文;血栓通治療腦出血的臨床觀察[N];醫(yī)藥經(jīng)濟(jì)報(bào);2006年

7 廣文;血栓通治療糖尿病周圍神經(jīng)病變的臨床觀察[N];醫(yī)藥經(jīng)濟(jì)報(bào);2006年

8 本報(bào)記者 譚欣;血栓通注射劑安全性再評(píng)價(jià)合作啟動(dòng)[N];中國(guó)中醫(yī)藥報(bào);2011年

相關(guān)碩士學(xué)位論文 前3條

1 耿遠(yuǎn)璋;腎靜脈上及肝上結(jié)扎家兔下腔靜脈對(duì)腎肝功能及血栓通對(duì)腎功能的影響[D];鄭州大學(xué);2016年

2 王玉平;血栓抽吸在急性STEMI患者PPCI術(shù)中的應(yīng)用研究[D];天津醫(yī)科大學(xué);2014年

3 席加喜;血栓通對(duì)順鉑腎損傷的體內(nèi)、外保護(hù)作用及其機(jī)制的研究[D];廣西醫(yī)科大學(xué);2012年

，

本文編號(hào)：1906485