自制腹透管尿毒症大鼠腹膜透析模型的建立

Establishment of peritoneal dialysis model in uremia rats with self-made peritoneal dialysis catheters

目的:建立一种便利、成功率高的尿毒症大鼠腹膜透析模型.方法:采用医用硅胶吸痰管作为腹膜透析管,应用无菌输液接头,手术采用腹部正中切口,出口选在后背颈部(自制1组)或近尾部(自制2组),与传统的选材和手术方式(传统头皮针组,出口同自制1组)进行对照.结果:自制1组、传统头皮针组腹透管完好,无管道破损和渗漏;自制2组管道完全咬破损坏.自制1组出口处或隧道口感染3例,传统头皮针组6例.自制1组腹膜炎发生1例,传统头皮针组3例.自制1组第1日与第15日相比腹膜透析出液量无统计学差异(P>0.05),头皮针组差异有统计学意义(P<0.01),第1日自制1组与头皮针组相比无统计学差异(P>0.05),第15日自制1组与头皮针组相比存在统计学差异(P<0.05).自制1组腹透管大网膜完全包裹1例,部分包裹5例;传统头皮针组完全包裹4例,部分包裹6例.结论:正确的手术方式,是模型建立的基本保证,而透析管道的选材、接头稳固耐用是腹膜透析模型能否长期使用的关键.

AIM： To develop an improved model of peritoneal dialysis in uremia rats. METHODS： Thirty SD rats were divided into three groups： experimental group 1, experimental group 2 and control group. In experimental groups, phlegm suction catheters were used as peritoneal dialysis catheters with tie-ins made from sterile transfuse connectors. The peritoneal dialysis catheters implanted into rats were tunneled subcutaneously to the nape （experimental group 1 ） or to the caudad part （experimental group 2）. Rats with traditional operation mode and traditional operation materials belonged to the control group. RESULTS： Peritoneal dialysis catheters in rats in experimental group 1 were intact, whereas catheters in rats in experimental group 2 were broken. Three rats in experimental group 1 and six rats in control group had tunnel opening infections. One rat in experimental group 1 and 3 rats in control group had peritonitis. In experimental group 1, the amount of exchanged solution on the first day of peritoneal dialysis was not different with that on the fifteenth day （P 〉0.05 ）, but in control group, the difference was significant （ P 〈0.01 ）. There was no difference between experimental group 1 and control group in the amount of exchanged solution on the first day （ P 〉0.05 ）, whereas there was significant difference on the fifteenth day （ P 〈0.05 ）. Peritoneal dialysis catheters were completely wrapped by omentums in 1 rat in experimental group 1 and in 4 rats in control group. Catheters were partly wrapped in 5 rats in experimental group 1 and in 6 rats in control group. CONCLUSION： Correct operation modes, proper operation material and firm durable catheter fie-ins are the key factors for developing a successful model of peritoneal dialysis.