开放性肾损伤治疗方法的探讨(动物实验)

Study on Therapeutic Methods for Penetrating Renal Injury

我们用11只犬进行丁实验研究,4只造成肾脏刀刺伤,7只动物以5.56mmMl93弹丸,重3.52克,速度为964M/S,射距20M,致肾脏枪弹伤。试图通过对开放性肾损伤病理改变的观察为治疗提供依据。实验结果表明,刀刺伤和高速枪弹伤是不同的。因此对肾脏刀剌伤的病人,有些情况下可采取非手术治疗,而对肾脏枪伤者,一经确诊,则应毫不犹豫地行手术探察。

We perfomed experimental study in 11 dogs. In 4 dogs, stab wounds to the left kidney were produced. 4 weeks after injury, no abnormal changes were found in IVP and ultrasonography; exploratory laparotomy showed slight adhesion between the affected kidney and the surrounding tissue. Grossly and microscopically no significant pathological changes were found. In 7 dogs were shot with 5.56mm M 139 bullet of 3.52Gm, at an initial velocity of 964M/Sec, from a distance of 20M, to produce kidney injury. Totally 13 kidneys were injuried. All but three were tangenital wounds to the kidney. The kidneys were badly lacerated, and there was tissue loss in varying extent. In the other 3 kidneys, there were multiple shallow lacerations and subcapsular hematomas, which were probably indirect injury resulting from temporary cavitation effect. All tissue samples from the wound track, outside of the wound track and renal vessel were sent for microscopical examination. The samples of 9 kidneys were examind with-electro-microscope, On the basis of the experimental results we believe that stab wounds are different from high velocity gunshot injuries. The former could possibly be treated conservatively.On the contrary, the bullet-injured should be operated on without delay as soon as diagnosis is established in order to preserve as much functional renal tissue as possible.