B-flow能量模式对兔闭合性肾损伤后血流灌注的动态观察

Dynamic Observation of Renal Perfusion in Rabbits with Blunt Renal Trauma Using B flow Power Mode

目的研究二维灰阶血流成像技术(B-flow)能量模式对兔闭合性肾损伤(blunt renal trauma,BRT)后肾血流灌注的特征。方法建立10只兔BRT模型。采用彩色多普勒和B-flow能量模式互相切换比较观察撞击伤1 h肾血流灌注的变化特征。之后,处死实验动物,取出伤肾,进行大体检查,并取样进行苏木精-伊红(hematoxylin-eosin,HE)染色,光镜下观察病变情况。结果 B-flow能量模式显示:撞击前,肾皮质灌注良好,肾髓质无明显血流信号。伤后即刻,肾包膜连续中断部位可见肾出血的血流信号,平均维持时间约4 s。肾实质血流灌注较伤前明显降低,之后,血流灌注逐渐增多,但至伤后1 h仍未恢复至伤前状态。大体标本显示,肾包膜破裂、肾实质挫裂伤并血肿形成、肾包膜下血肿。光镜下可见肾细胞发生不同程度损伤,肾毛细血管充血,肾小管见红细胞管型和蛋白管型。结论B-flow能量模式能较清晰显示兔BRT血流灌注情况,可为救治和评估疗效提供重要参考信息。

Objective To investigate the characteristics of renal perfusion in rabbits with blunt renal trauma on B-flow power mode. Methods Ten cases model rabbits with blunt renal trauma were studied. One-hour observation of renal perfusion in each case after strike was performed by switches between B flow power mode and Color Doppler Flow Imaging （CDH）. Rabbits were then sacrificed and their kidneys were harvested for general examinations. Lesions were observed by optical microscopy after hematoxylin-eosin （HE） staining, Results As indicated by B flow power mode, be- fore strike, the renal cortical blood perfused well, and no obvious blood flow signal was seen in renal medulla. Right after impacted, blood signal running out of the kidney was detected for average of 4 seconds where renal capsule was interrupt- ed. The blood perfusion of renal parenchyma decreased significantly compared with that before hurt. Then the perfusion increased gradually, but didn＇t recover to the normal level in 1 hour. Rupture of renal capsule, renal contusion with hema- toma formation and subcapsular hematoma were demonstrated by gross specimen. Light microscope showed that renal cells were injured in different degrees, blood capillaries were hyperemia, and the renal tubules were filled with red blood cells and protein. Conclusion B-flow power mode can show the renal perfusion of rabbits with blunt renal trauma clearly, which provides important reference for treatments and therapy,