输尿管导管逆行灌注凝血酶对大鼠肾脏穿刺术后出血的影响

目的应用逆行输尿管导管灌注凝血酶溶液观察大鼠肾脏出血肉眼血尿局部止血的疗效。方法通过单侧肾穿刺配合全身肝素化制备大鼠肾脏出血肉眼血尿模型。32只SD大鼠模型随机分作4组,分别以低、中、高三种不同浓度的凝血酶及生理盐水经输尿管导管行该侧肾盂逆行灌注。检测灌注前及灌注后各组大鼠尿红细胞计数值、外周血血色素水平、出血时间、凝血时间及血肌酐水平等指标。结果三种不同剂量的凝血酶溶液组灌注后尿红细胞计数水平与生理盐水对照组相比均有显著差异（P〈0.05）;其中凝血酶溶液中、高剂量组给药后5min及40 min尿红细胞计数水平均显著低于低剂量组（P〈0.05）;不同剂量的凝血酶溶液组与生理盐水对照组在灌注后40 min检测的大鼠外周血血色素水平比较均有明显差异（P〈0.05）;其中凝血酶中、高剂量组灌注后40min大鼠外周血血色素水平显著高于低剂量组（P〈0.05）。灌注凝血酶溶液前、后的出血时间、凝血时间及血肌酐水平均无明显变化（P〉0.05）。结论逆行灌注凝血酶溶液对大鼠肾穿刺术后严重的肾出血有明显迅速的止血效果,且有一定的量效依存关系;同时对大鼠凝血功能及肾功能未发现明显影响。     

Challenges and Opportunities in Radiation-induced Hemorrhagic Cystitis

As diagnosis and treatment of cancer is improving, medical and social issues related to cancer survivorship are becoming more prevalent. Hemorrhagic cystitis (HC), a rare but serious disease that may affect patients after pelvic radiation or systemic chemotherapy, has significant unmet medical needs. Although no definitive treatment is currently available, various interventions are employed for HC. Effects of nonsurgical treatments for HC are of modest success and studies aiming to control radiation-induced bladder symptoms are lacking. In this review, we present current and advanced therapeutic strategies for HC to help cancer survivors deal with long-term urologic health issues.