中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2010年
2期
128-131
,共4页
孙俊杰%王文卫%邓高燕%汪凤华%莫家骢
孫俊傑%王文衛%鄧高燕%汪鳳華%莫傢驄
손준걸%왕문위%산고연%왕봉화%막가총
模型%动物%肾盂积水%先天性%输尿管梗阻
模型%動物%腎盂積水%先天性%輸尿管梗阻
모형%동물%신우적수%선천성%수뇨관경조
Models,animal%Hydronephrosis,congenital%Ureteral obstruction
目的 探讨胎儿期解除单侧输尿管不完全梗阻的效果.方法 取22只健康孕羊在妊娠第75至85天采用宫内手术的方法 造成胎羊左侧输尿管不完全梗阻.然后分为二组,第一组12只继续妊娠,第二组10只三周后再次手术去除胎羊输尿管上的硅胶环和丝线以解除梗阻.对羔羊进行影像、病理学研究.结果第一组12只孕羊中有3只流产,有9只孕羊顺产羔羊;第二组10只孕羊中有2只流产,有8只孕羊顺产羔羊.第一组羔羊左肾均可见增大、积水和肾功能损害;第二组羔羊左肾大小、肾功能正常,左肾盂无扩张,但表面不平滑、肾实质较薄.组织学上,第二组羔羊左肾肾小球数目无减少,肾小管扩张也较第一组羔羊左肾轻.结论 胎儿期解除单侧输尿管不完全梗阻,可以及时阻止病程进展,使梗阻解除肾在形态和功能上都可得到较好的恢复.
目的 探討胎兒期解除單側輸尿管不完全梗阻的效果.方法 取22隻健康孕羊在妊娠第75至85天採用宮內手術的方法 造成胎羊左側輸尿管不完全梗阻.然後分為二組,第一組12隻繼續妊娠,第二組10隻三週後再次手術去除胎羊輸尿管上的硅膠環和絲線以解除梗阻.對羔羊進行影像、病理學研究.結果第一組12隻孕羊中有3隻流產,有9隻孕羊順產羔羊;第二組10隻孕羊中有2隻流產,有8隻孕羊順產羔羊.第一組羔羊左腎均可見增大、積水和腎功能損害;第二組羔羊左腎大小、腎功能正常,左腎盂無擴張,但錶麵不平滑、腎實質較薄.組織學上,第二組羔羊左腎腎小毬數目無減少,腎小管擴張也較第一組羔羊左腎輕.結論 胎兒期解除單側輸尿管不完全梗阻,可以及時阻止病程進展,使梗阻解除腎在形態和功能上都可得到較好的恢複.
목적 탐토태인기해제단측수뇨관불완전경조적효과.방법 취22지건강잉양재임신제75지85천채용궁내수술적방법 조성태양좌측수뇨관불완전경조.연후분위이조,제일조12지계속임신,제이조10지삼주후재차수술거제태양수뇨관상적규효배화사선이해제경조.대고양진행영상、병이학연구.결과제일조12지잉양중유3지유산,유9지잉양순산고양;제이조10지잉양중유2지유산,유8지잉양순산고양.제일조고양좌신균가견증대、적수화신공능손해;제이조고양좌신대소、신공능정상,좌신우무확장,단표면불평활、신실질교박.조직학상,제이조고양좌신신소구수목무감소,신소관확장야교제일조고양좌신경.결론 태인기해제단측수뇨관불완전경조,가이급시조지병정진전,사경조해제신재형태화공능상도가득도교호적회복.
Objective To investigate the efficacy of antenatal correction of unilateral partial ure-teral obstruction in fetal lambs. Methods Twenty two healthy pregnant ewes were underwent intrau-terine operation between 75 and 85 days of gestation to induce unilateral partial urethral obstruction on fetuses. The ewes were randomly divided into 2 groups. Twelve ewes of Group 1 were allowed to con-tinue pregnancy until delivery. On the 10 ewes of Group 2,the second intrauterine operations were performed to remove the silastic rings and the silk sutures on the ureter of fetuses three weeks after the first surgery. The kidneys of the neonatal lambs were harvested and studied histologically. Results In Group 1,three ewes aborted after surgery,nine ewes delivered normally. In Group 2,two ewes aborted after the second operation,the other 8 ewes delivered living lambs. Hydronephrosis and renal function impairment were found on the left kidneys of Groupl lambs. On the lambs of Group 2,nor-mal sizes left kidneys without hydronephrosis were noted,but the kidneys had unsmooth surface and thin renal parenchyma. Histological examination revealed that the number of glomerulus in the left kidneys of neonatal lambs from Group 2 were still normal. Compared with Group 1,the severity of tu-bules dilation was alleviated in Group 2. Conclusions The surgical relief of urethral obstruction on fe-tuses prevents the progression of nephropathy. The renal function will be preserved or even recovered after antenatal surgery.
