摘要
目的探究家兔肾移植围术期静脉血气值与家兔肾移植预后的关系。方法应用家兔在体肾脏低温机械灌注(HMP)方式建立家兔自体肾移植模型。根据血气分析分为A组和B组,A组为术中血气值维持在正常范围内,B组为术中血气值下降。术中术后统计每只家兔静脉血气值变化情况,分析术后家兔生存率、24小时后肌酐、尿量与家兔血气值变化情况的相关性。结果根据家兔术中血气值变化情况分为两组,A组家兔6只灌注过程中家兔血气值基本保持不变,B组家兔8只在灌注过程中p H呈下降趋势(7.40±0.02比7.05±0.08,P<0.001),碱剩余值(BE值)与HCO3-明显下降[BE:-1.00±1.58比-9.42±1.89,P<0.001;HCO_3^-(mmol/L):20.34±1.11比14.68±1.44,P<0.05)]。与A组家兔相比,B组家兔术后生存率明显下降(83.3%比62.5%,P<0.05),24小时后肌酐、尿素氮明显升高[肌酐(μmol/L):342.00±18.81比518.00±23.54,P<0.001;尿素氮(mmol/L)9.20±2.01比23.40±3.33 mol/L,P<0.05],尿量明显降低(116.80±6.55 ml/d比75.20±6.94 ml/d,P<0.05)。结论家兔机械灌注过程中血气值的稳定与家兔肾移植预后有一定的相关性,血气值稳定的家兔预后较好,酸中毒家兔其生存率及肾功能均欠佳。因此,在机械灌注过程中有必要采取一定干预措施保持家兔内环境的稳定性。
Objective To clear the relationship between perioperative venous blood gas results and prognoses of rabbit kidney transplantation. Methods The rabbit autologous kidney transplantation models were established using a rabbit hypothermic machine perfusion. Results Rabbits were grouped, according to changes of blood gas values. The blood gas values of rabbits in group A were unchanged during perfusion. The p H values of blood samples in group B were decreased during the perfusion（7.40±0.023 vs. 7.05±0.08,P 0.001）. Compared with group A,the BE and HCO_3^-values of group B were significantly decreased [BE ：-1.00±1.58 vs.-9.42±1.89, P 0.001;HCO3-（mmol/L）：20.34±1.11 vs. 14.68±1.44,P 0.05]. The survival rate of group B was significantly lower than that of group A（62.5% vs. 83.3%, P 0.05）. In group B, the urine outputs were significantly lower after reperfusion（ml/d ：116.80±6.55 vs.75.20±6.94,P 0.05） and the creatinine and urea nitrogen were significantly increased [creatinine（umol/L）： 342.00±18.81 vs. 518.00±23.54,P 0.001;urea nitrogen（mmol/L）：9.20±2.01 vs. 23.40±3.33, P 0.05） ]. Conclusion The stability of blood gas in rabbits during mechanical perfusion has some correlation with the prognosis of rabbit kidney transplantation. Therefore, during the process of hypothermic machine perfusion,specific managements should be given to maintain the stability of the internal environment of the rabbit.
作者
薛帅
钟自彪
兰佳男
胡前超
向涛
熊艳
王彦峰
叶啟发
Xue Shuai,Zhong Zibiao,Lan Jianan,Hu Qianchao,Xiang Tao,Xiong Yan,Wang Yanfeng,Ye Qifa(1. Wuhan University, Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan 430071, Hubei, China ; 2. Research Center of National Health Ministry on Transplantation Medicine Engineering and Technology, The 3rd Xiangya Hospital of Central South University, Changsha 410013, Hunan, Chin)
出处
《实用器官移植电子杂志》
2018年第1期30-33,共4页
Practical Journal of Organ Transplantation(Electronic Version)
基金
国家自然科学基金新疆联合项目(U1403222)
关键词
血气检测
肾移植
自体肾移植
家兔在体低温机械灌注模型
预后
Blood gas detection
Kidney transplant
Autotransplantation
Rabbit in vivohypothermic machine perfusion
Prognosis
