CAJ | 학술논문

目的探讨生物可降解雷帕霉素输尿管支架修复战创伤性输尿管损伤的可行性和有效性.方法自行设计定位爆炸装置,构建战创伤输尿管损伤动物模型.生物可降解雷帕霉素输尿管支架和双J管分别置入损伤段输尿管,6周时模拟临床实际取出双J管,通过静脉肾盂造影(IVP)、肾图及组织学方法评估生物可降解雷帕霉素输尿管支架修复输尿管战创伤的可行性和有效性.结果术后18周,影像学检查生物可降解雷帕霉素输尿管侧未见明显输尿管支架影,提示支架已降解排出,输尿管引流通畅;而双J管侧输尿管及肾盂出现中、重度积水;肾图提示双J管侧肾小球滤过率由术前(32.10±3.56) ml/min下降至(15.00±3.35) ml/min,半排时间由术前(4.80±0.75)s延长至(13.10±1.26)s;而生物可降解雷帕霉素输尿管支架侧,各时间点肾功能差异无统计学意义(P＞0.05).组织学检查证实雷帕霉素输尿管支架侧组织反应轻,生物相容性好.结论生物可降解雷帕霉素输尿管支架可有效地修复输尿管损伤,具有更好的生物相容性.
목적 탐토생물가강해뢰파매소수뇨관지가수복전창상성수뇨관손상적가행성화유효성.방법 자행설계정위폭작장치,구건전창상수뇨관손상동물모형.생물가강해뢰파매소수뇨관지가화쌍J관분별치입손상단수뇨관,6주시모의림상실제취출쌍J관,통과정맥신우조영(IVP)、신도급조직학방법평고생물가강해뢰파매소수뇨관지가수복수뇨관전창상적가행성화유효성.결과 술후18주,영상학검사생물가강해뢰파매소수뇨관측미견명현수뇨관지가영,제시지가이강해배출,수뇨관인류통창;이쌍J관측수뇨관급신우출현중、중도적수;신도제시쌍J관측신소구려과솔유술전(32.10±3.56) ml/min하강지(15.00±3.35) ml/min,반배시간유술전(4.80±0.75)s연장지(13.10±1.26)s;이생물가강해뢰파매소수뇨관지가측,각시간점신공능차이무통계학의의(P＞0.05).조직학검사증실뢰파매소수뇨관지가측조직반응경,생물상용성호.결론 생물가강해뢰파매소수뇨관지가가유효지수복수뇨관손상,구유경호적생물상용성.
Objective To evaluate the feasibility and effectiveness of the biodegradable rapamycin-eluting stent in the treatment of ureteral traumatic injury.Methods The anima traumatic ureteral injury model was made by a self-designed explosion device.Both biodegradable rapamycin-eluting ureteral stent and double-J stent were surgically implanted into the ureters.By intravenous pyelography (IVP),radioactive renography and histological findings at different time points,the feasibility and effectiveness of the biodegradable rapamycin-eluting ureteral stent in the treatment of ureteral injury were evaluated.Results After 18 weeks,no obvious signs of biodegradable rapamycin-eluting stent were found,which indicated that the stent was degraded.IVP demonstrated that the ureters on the biodegradable rapamycin-eluting stent side were smooth and clear,while moderate to severe hydronephrosis appeared on the double-J stent side.Renography examinations showed on the double-J stent side,the glomerular filtration rate was decreased from (32.10 ±3.56) ml/min to (15.00 ±3.35) ml/min,and C1/2 time extended from (4.80 ±0.75) s to (13.10 ± 1.26) s,while on the biodegradable rapamycin-eluting stent side,the renal function showed no significant difference at each time point.Histological results indicated the tissue reactions were milder on the biodegradable rapamycin-eluting stent side than on the double-J stent side,and no signs of scar formation were found.Conclusion The biodegradable rapamycin-eluting stent showed favorable therapeutic prospects in the treatment of ureteral traumatic injury with good biocompatibility as compared with double-J stent.