输尿管梗阻对肾盂内压和肾功能的影响

目的 探讨不同时间段输尿管梗阻对肾盂内压和肾功能的影响.方法 采用新西兰大白兔56只,随机分为正常对照组8只、假手术组8只和手术组40只.假手术组只显露而不结扎左侧输尿管,手术组将左侧输尿管完全结扎.分别于输尿管梗阻后3d、1周、2周、4周、8周后测定兔肾盂内压.于梗阻前及梗阻后3d、1周、2周、4周、8周留取兔尿液,应用FM-8P全自动冰点渗透压计测定梗阻前后尿渗透压(Uosm)变化.分别于输尿管梗阻前后行99mTe-DTPA肾动态显像检查并测定兔肾小球滤过率(GFR)变化.结果 (1)输尿管梗阻2周后,兔肾盂内压上升到最高为28.5cmH2O,8周后肾盂内压仍然维持很高水平,与假手术组相比差异有统计学意义(P＜0.01).(2)随着输尿管梗阻时间的延长,GFR进行性降低,尿液浓缩功能逐渐下降.结论 肾功能损害随输尿管梗阻时间的延长而加重,与梗阻侧持续肾盂内压升高有关.

Effects of ureteral obstruction on intrapelvic pressure and renal function

Objectives To explore the effects of variable periods of ureteralobstruction on intrapelvic pressure and renal function.Metheds Fifty-six adult NewZealand rabbits were used in the experiment and were randomly divided into normal control group(n=8),sham operation group(n-8)and operation group(n=40).In sham operation group,left ureter was only exposed and not ligated;in operation group,left ureter was ligated completely.Intrapelvic pressure was measured 3 days,1 week,2 weeks,4 weeks,8 weeks respectively after ureteral obstruction.Urine was collected before obstruction and 3 days,1 week,2 weeks,4 weeks,8 weeks respectively after ureteral obstruction.Urine osmolarity was measured with Autoosmometer.Glomerular filtration rate was monitored by 99mTc-DTPA dynamic renalimaging before and after ureteral obstruction.Results 1)Ntrapelvic pressure rised highlestly to 28.5cmH2O during 2 weeks'ureteral obstruction and maintained high level after 8 weeks' complete obstruction.The mean intrapelvic pressure in sham operation group differed significantly from that in operation group(P<0.01).2)With increasing duration of ureteral obstruction there was a progressive decline in GFRand the urine osmolality decreased progressively with time.Conclusion With increasing duration of ureteral obstruction the renal function damage is increased gradually and associated with the lasting high level intrapelvic pressure.