一种改良的腹膜透析大鼠模型建立

Establishment of an improved peritoneal dialysis model in rats

目的对传统腹膜透析模型进行改良,建立一种技术生存率高的腹膜透析大鼠模型。方法选用60只雄性SD大鼠,随机分为6组。根据腹膜透析管口在腹腔内位置将其分为:正常对照组、假手术组、左上腹组、右上腹组、中腹组和下腹组。左上腹组腹膜透析管管口置于左上腹胃区,右上腹组腹膜透析管管口置于右上腹肝区,中腹组腹膜透析管管口置于右中腹盲结肠区,下腹组和假手术组腹膜透析管采用传统置管方法,管口位于膀胱直肠窝附近。手术完成1周后,左上腹组、右上腹组、中腹组和下腹组大鼠每日透析1次,腹膜透析液20ml,留腹1h。观察腹膜透析1周后腹膜透析技术生存率、腹膜超滤量、体质量、白蛋白和腹膜透析安全性指标(血常规和血生化)。结果腹膜透析各组大鼠第1天腹膜透析管均通畅。腹膜透析1周后,总体技术生存率为30.8%(12/39)。右上腹腹膜透析置管组技术生存率最高,达到80%,明显高于其余3组(χ~2=16.675,P=0.001);腹膜透析管堵塞原因以大网膜阻塞为主,占50%,下腹组腹膜透析管堵塞原因主要为大鼠睾丸附着脂肪;4种手术方式下大鼠超滤量(F=1.812,P=0.163)无统计学差异,白蛋白(F=2.307,P=0.084)、红细胞比容(F=1.258,P=0.311)、血钾(F=1.101,P=0.376)和血钠(F=1.134,P=0.323)无明显差异。结论右上腹肝区腹膜透析置管术是一种优于传统方法的改良大鼠腹膜透析建立方法,长时腹膜透析技术生存率更高。

Objective To improve the traditional peritoneal dialysis(PD)model,we established an improved PD model with higher survival rate in rats.Method Sixty male SD rats were randomly divided into 6 groups of normal control group,sham operation group,left upper abdomen group,right upper abdomen group,middle abdomen group and lower abdomen group.The orifice of the dialysis tube was placed in the upper left gastric region in rats of left upper abdomen group,in the upper right hepatic region in rats of right upper abdomen group,in the middle right cecum-colon region in rats of middle abdomen group,and near rectumvesical fossa using traditional surgery in rats in lower abdomen group and sham operation group.After the surgery for one week,PD(dialysate 20ml,hold for one hour)was performed once daily in rats in left upper abdomen group,right upper abdomen group,middle abdomen group and lower abdomen group.After PD for one week,PD technical survival rate,ultrafiltration volume,body weight,serum albumin and peritoneal dialysis safety index were evaluated.Results No obstruction of the dialysis tubes was observed at the first day of the operation.The overall survival rate was 30.8%(12/39)after PD for one week.Rats in right upper abdomen group had the highest PD technical survival rate(80%),significantly higher than that of the other three groups(χ^2=16.675,P=0.001).There were no significant differences in ultrafiltration volume(F=1.812,P=0.163),serum albumin(F=2.307,P=0.084),erythrocyte volume(F=1.258,P=0.311),serum potassium(F=1.101,P=0.376)and sodium(F=1.134,P=0.323)among the four groups.Conclusion PD tube placed in the upper right hepatic region was a better method than the traditional method for the establishment of PD in rats,with a higher survival rate for long-term PD.