肾静脉上结扎大鼠下腔静脉及合并右肾切除后的肾功能改变和川芎嗪对其的影响

目的　探讨肾静脉平面以上结扎大鼠下腔静脉、合并右肾切除及应用川芎嗪后的肾功能及肾脏病理改变。方法　分别在肾静脉平面以上结扎大鼠下腔静脉、肾静脉平面以上结扎下腔静脉并右肾切除、肾静脉平面以上结扎下腔静脉并川芎嗪治疗 ,术后第 6、12、2 4小时 ,2、3、4、5、7天检测血肌酐、尿素氮、2 4h尿量及N 乙酰 D 氨基葡萄糖酶 (NAG)并观察肾脏病理改变。结果　肾静脉平面以上结扎大鼠下腔静脉后血肌酐、尿素氮、尿NAG升高 ,肾脏淤血并见大量管型。术后第 3天 ,肾脏恢复正常结构 ;术后第 4天 ,血肌酐、尿素氮恢复正常 ;术后第 5天 ,尿ANG恢复正常。肾静脉平面以上结扎下腔静脉并右肾切除术后第 5天 ,血肌酐、尿素氮、尿NAG恢复正常 ,肾脏淤血较重 ,部分动物 2 4h内死亡。肾静脉平面以上结扎下腔静脉并川芎嗪治疗术后第 4天 ,血肌酐、尿素氮、尿NAG酶恢复正常 ,肾脏淤血较轻。结论　肾静脉平面以上结扎大鼠下腔静脉可因双肾淤血而影响肾功能 ,但术后第 5天即可完全代偿。若在肾静脉平面以上结扎下腔静脉并右肾切除 ,不但增加手术难度和风险 ,还能进一步损害肾功能 ,增加术后 2 4h动物死亡率。若在肾静脉平面以上结扎下腔静脉附加川芎嗪治疗 ,可明显改善肾功能。建议当遇病人患有腹膜后肿瘤侵及肾静脉?

Renal function changes following suprarenal ligation of the inferior vena cava and the resection of the right kidney or injection of ligustrazine in rats

Objective To investigate the renal function following suprarenal ligation of the inferior vena cava (IVC) and that plus resection of right kidney or that plus injection of ligustrazine in rats.Methods To measure blood urea nitrogen (BUN),serum creatinine (SCr),N-acetly-D-glucosaminidase (NAG)/24 hrs,urinary output/24 hrs and to detect renal pathology at 6th hour,12th hour,24th hour,and on 2nd day,3rd day,4th day,5th day,and 7th day after the suprarenal ligation of the IVC/and the resection of the right kidney or injection of ligustrazine.Results The levels of BUN,SCr,urine NAG/24 hrs rose and there were congestion and many casts in the kidneys.Renal texture returned to normal on 3rd day after operation,BUN,SCr returned to normal levels on 4th day,urine NAG/2 hrs returned to normal level on 5th day after operation.BUN,SCr,urine NAG/24 hrs returned to normal levels on 4th day after the suprarenal ligation of the IVC and resection of the right kidney,the congestion of kidney was serious and some rats died.BUN,SCr,wrine NAG/24 hrs returned to normal levels on 4th day after the suprarenal ligation of the IVC and injection of ligustrazine;the congestion of kidneys was slight.Conclusions The renal function was affected by congestion of two kidneys following the suprarenal ligation of the IVC,but returned to normal level on 5th day after the operation.The suprarenal ligation of the IVC and resection of right kidney increased the operative difficulty,danger,and the death rate of experimental rats.The suprarenal ligation of the IVC and injection of ligustrazine can improve renal function obviously.It is suggested that in case of retroperitoneal tumor with involved suprarenal IVC the resection of the tumor and the involved IVC segment followed by ligating its stump,but without resecting the right kidney,concurrently plus the injection of ligustrazine,can protect the patient′s renal function.