自制冷盐水囊对腹腔镜手术中的肾低温保护作用

Hypothermia renoprotection with self-made cold-saline-perfused capsule in the porcine model

目的采用自制冷盐水囊装置给肾脏降温，在猪模型腹腔镜肾部分切除术中达到肾低温保护的目的。方法健康家猪5头，模拟腹腔镜肾部分切除手术，在肾动脉阻断后，用冷盐水囊包绕肾脏降温，并维持肾脏低温状态。结果肾动脉阻断后，采用1～2℃生理盐水灌注水囊包裹。肾脏降温，使肾脏温度在13min内降到25℃以下，之后肾实质温度继续下降，最终稳定于17～19℃。实验过程中，中心温度稳定（波动〈1℃）。肾标本病理显示，受低温保护的肾脏未见明显缺血性形态改变。结论在猪模型腹腔镜肾部分切除术中，应用冷盐水囊降温，可以维持肾低温，达到肾低温保护的目的。

Objective To achieve hypothermia renoprotection in the laparoscopic partial nephrec- tomy with self-made cold-saline-perfused capsule in the porcine model. Methods Five domestic pigs un- derwent laparoscopic partial nephrectomy. After occlusion of the renal artery, the kidney was enveloped with cold-saline-perfused capsule to maintain hypothermia. Results After complete occlusion of the renal artery, a cold-saline （ 1-2℃ ）-perfused capsule enveloping the kidney was applied to decrease the tempera- ture below 25.0℃ within 13 min and finally stabilize at 17-19 ℃. The core body temperature was main- tained stable （fluctuation 〈 1 ℃ ） within the procedure. No ischemic changes were noted on histologie re- view of the renal biopsy specimens. Conclusion Application of cold-saline-perfused capsule to the retroperitoneal laparoscopie partial nephreetomy in the porcine model effectively maintains hypothermia and pro- tects renal function.