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。

Haemostasis Effect of Retroperfusion Thrombase Through Ureteral Catheter on Nephrorrhagia Rats

Objective To investigate haemostasis effect of thrombase retroperfusion through ureteral catheter on nephrorrhagia rats.Methods After renal biopsy with systemic heparinization,the models of nephrorrhagia rats with gross hematuria had been established,32 SD rats weighing 350~400g were divided into 4 groups randomly（8 rats in each group）.All rats were retroperfused by three different doses of thrombase or NS through ureteral catheter respectively.Lab index： Urinary red cell,blood pigment,serum creatinine,bleeding time（BT） and clotting time（CT） were detected in all rats before retroperfusion,5 min and 40 min after retroperfusion.Results ①Compared with NS group,the level of red blood cell count in urine of the other 3 groups was significantly different respectively（P0.05）,and the level of above-mentioned index among high-dose group and middle-dose group was lower than low-dose group（P0.05）.While the difference of blood pigment between different distinctive dose groups and NS group was significant in 40 min after retroperfusion（P0.05）.The level of above-mentioned index among high-dose group（500U/mL）and middling-dose group（250 U/mL）was distinguished higher versus low-dose group respectively.②Among 4 groups,the difference of bleeding time（BT）、clotting time（CT） and serum creatinine between the former and the latter was not significant（P0.O5）.Conclusion All three different doses of thrombase had haemostasis effect on renal hemorrhage rats by retroperfusion through ureteral catheter,and the effects were related to the medicament and the dosage;while retroperfusion thrombase did not affect BT,CT and the level of serum creatinine of rats.