几种缺血原位肾保护方法的比较实验研究——组织学及组织化学观察

A HISTOLOGICAL AND HISTOCHEMICAL STUDY OF SOME PRESERVATING METHODS IN LOCAL ISCHEMIC KIDNEY

本文对局部低温、低温平衡液附加其它药物灌注等五种保护缺血肾的方法,在13只狗的实验中进行了组织学及组织化学的初步观察和比较。实验结果表明:A组(局部低温)、D组(局部低温加肝素)及E组(局部常温)实验处理四小时内的不同间隔及停止处理后存活30~60天的取材标本中均显示了不可逆的组织学变化。琥珀酸脱氢酶、碱性磷酸酶、三磷酸腺苷酶均于实验处理1~2小时后开始减少,四小时后呈弱阳性或阴性反应,反应肾组织因缺血受损程度严重,说明这三种护肾措施对缺血肾保护作用不明显。B组(低温灌注液加普鲁卡因及肝素灌注)实验处理时组织学及组织化学变化轻微,实验处理后60天所有变化基本恢复。C组(低温灌注液加甘露醇、硫酸镁、ATP及肝素灌注),实验处理时及处理后60天均未发现组织学及组织化学有异常变化,说明该组措施对缺血肾的保护效果较其余各组为佳。

A comparative observation about histological and histochemical study were made onthe preservating methods of local ischemic kidney of dogs.The methods of this exp-eriment were divided into five groups:A.Local hypothermia;B.Hypothermic perfu-sion solution 500ml,4℃,containing Procaine 450 mg and Heparin 100 mg,infusedinto renal artery;C.Hypothermic perfusion solution 500ml,4℃,containing 20%Ma-nniton 32ml,25%MgSO0.36 ml,Heparin 100 ml,infused into renal artery;D.Localhypothermia and heparin 30 mg injected into the same vessel.E.Local room tem-perature.The specimens were taken from the kidneys of the experimental dogs atvarious period after treated with every method.The results were as follows;A,D and E group presented irreversible histological changes within 4 hoursaftertreatment.Four hours later,the reaction of SDH,ATPase,AlPase werenegative.It suggested that the kidney damage was serious,as well as expressed thatthe effect of these preservating methods for ischemic kidney are not satisfactory.In B group,the histological and histochemical alteration is very light and almostreversible,during 60 days after treatment.In C group,hypothermic perfusionsolution containing Mannitol,MgSOetc either during experiment or follow observa-tion for 60 days,no histological and histochemical alterations were found.It indica-ted that this method is an ideal perservating technique for ischemic kidney.