【摘要】：目的建立犬急性腎衰竭(ARF)模型,觀察野戰(zhàn)機(jī)動(dòng)式連續(xù)性血液凈化系統(tǒng)在高原環(huán)境(海拔3640m)下工作的穩(wěn)定性、有效性及安全性。方法選擇成年比格犬,外科行雙腎切除術(shù)制作致ARF模型,應(yīng)用野戰(zhàn)機(jī)動(dòng)式連續(xù)性血液凈化機(jī)行持續(xù)靜-靜脈血液濾過治療。應(yīng)用自身對(duì)照方法觀察治療前后動(dòng)物模型生命體征、肝功能、腎功能及血清離子水平變化。檢測(cè)高原環(huán)境下野戰(zhàn)機(jī)動(dòng)式連續(xù)性血液凈化系統(tǒng)的工作性能。結(jié)果 6只犬術(shù)后24h血尿素氮(BUN)、肌酐(Cr)升高,與術(shù)前比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),符合ARF診斷標(biāo)準(zhǔn)。3只犬行頸外靜脈血液透析用雙腔靜脈導(dǎo)管置管,3只犬行股靜脈置管;5只犬完成全部實(shí)驗(yàn),1只犬因透析管脫落,失血死亡。與治療前比較,ARF犬治療后2、4h,平均動(dòng)脈壓、心率、呼吸頻率與治療前比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。血清丙氨酸轉(zhuǎn)氨酶(ALT)、天冬氨酸轉(zhuǎn)氨酶(AST)及總膽紅素(T-Bil)水平與治療前比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。血清BUN及Cr水平較治療前下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。血清K+水平下降,與治療前比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療過程中無出血、過敏、低血壓等并發(fā)癥發(fā)生。野戰(zhàn)機(jī)動(dòng)式連續(xù)性血液凈化系統(tǒng)對(duì)異常情況反應(yīng)敏感、報(bào)警迅速。治療前后系統(tǒng)設(shè)置與實(shí)際測(cè)得的置換液、廢液量誤差分別為0.273%±0.015%、0.182%±0.014%,差異無統(tǒng)計(jì)學(xué)意義(P0.05),符合國家行業(yè)標(biāo)準(zhǔn)。結(jié)論高原環(huán)境下野戰(zhàn)機(jī)動(dòng)式連續(xù)性血液凈化系統(tǒng)工作性能穩(wěn)定,對(duì)ARF治療安全、有效。
[Abstract]:Objective to establish a canine (ARF) model of acute renal failure (ARF) and to observe the stability, efficacy and safety of continuous field mobile blood purification system working at high altitude (3640m). Methods the ARF model was made by bilateral nephrectomy in adult Beagle dogs, and continuous venovenous hemofiltration was performed with field maneuvering continuous blood purification machine. The changes of vital signs, liver function, renal function and serum ion levels were observed before and after treatment. The working performance of mobile continuous blood purification system in high altitude environment was tested. Results the blood urea nitrogen (BUN),) creatinine (Cr) increased 24 hours after operation in 6 dogs, which was significantly higher than that before operation (P0.05), which was in accordance with the diagnostic criteria of ARF. 3 dogs underwent external jugular vein hemodialysis with double vena cava catheters. 3 dogs underwent femoral vein catheterization. All the experiments were completed in 5 dogs. One dog died of blood loss due to dialysis tube falling off. Compared with before treatment, the mean arterial pressure, heart rate and respiratory frequency of ARF dogs were not significantly different from those before treatment (P0.05). The levels of serum alanine aminotransferase (ALT),) aspartate transaminase (AST) and total bilirubin (T-Bil) were not significantly different from those before treatment (P0.05). The levels of serum BUN and Cr were significantly lower than those before treatment (P0.05). Serum K level decreased, compared with the treatment before the difference was statistically significant (P0.05). No bleeding, hypersensitivity, hypotension and other complications occurred during the treatment. The field maneuvering continuous blood purification system is sensitive to abnormal situations and alarm is rapid. Before and after treatment, the system setup and the actual measurement of the displacement liquid, the amount of waste liquid error was 0.273% 鹵0.015% 鹵0.014%, the difference was not statistically significant (P0.05), in line with the national industry standards. Conclusion the field mobile continuous blood purification system has stable working performance and is safe and effective in the treatment of ARF at high altitude.
【作者單位】： 解放軍309醫(yī)院器官移植研究所;北京奧佳盛康科技發(fā)展有限公司;
【基金】：北京市科技專項(xiàng)2011階梯計(jì)劃項(xiàng)目(Z111102055311086)~~
【分類號(hào)】：R82

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