Mo J, Wang X
Department of Pediatric Surgery, First Hospital Affiliated to Sun Yat-sen University of Medical Sciences, Guangzhou 510089, China.
Zhonghua Yi Xue Za Zhi. 2001 Jul 10;81(13):798-800.
To study the process of recovery of peristaltic function at anastomotic stoma after dismembering pyeloplasty in rabbits.
An animal model of obstructive hydronephrosis was made with 32 New Zealand rabbits. These rabbits were divided into four groups to be examined within the first, second, third, and fourth week respectively after a dismembering pyeloplasty was performed on them, eight rabbits in each group. Thirty-two normal New Zealand rabbits were divided into four corresponding control groups as controls. Pressures of the renal pelvis and upper ureter were measured, electromyogram was recorded, and histological examination was made to the tissue of anastomotic stoma before and after the operation.
In the normal control rabbits, the resting pressure was (10.8 +/- 1.3) mm Hg, contraction amplitude was (1.6 +/- 0.4) mm Hg, pulse amplitude of EMG was (0.39 +/- 0.10) mV, and pulse frequency was (5.4 +/- 1.0)/min in the renal pelvis; and the resting pressure was (11.7 +/- 1.7) mm Hg, contraction amplitude was (1.8 +/- 0.5) mm Hg, pulse amplitude of EMG was (0.38 +/- 0.08) mV, pulse frequency was (5.3 +/- 0.9)/min in the upper ureter. Within the first week after operation, the resting pressure of renal pelvis was (14.4 +/- 1.3) mm Hg, significant higher than normal (P < 0.05), the contraction amplitude of renal pelvis was (1.1 +/- 0.4) mm Hg, lower than normal (P < 0.05); the pulse amplitudes of EMG in renal pelvis (0.19 +/- 0.05) mV and in upper ureter (0.26 +/- 0.04) mV were lower than normal (P < 0.05). A thin layer of mucosa was seen covering the anastomotic stoma. In the second week after operation, no statistical difference was observed in resting pressure, contraction amplitude, amplitude of EMG, and frequency of EMG in renal pelvis between the experimental rabbits and the controls (P > 0.05). Newborn smooth muscle cells were seen running through the anastomotic stoma, and close contact was observed among the cells. Within the third week after operation, the pressures and EMG in renal pelvis and in upper ureter were not significantly different from those in normal rabbits (P > 0.05). Nerve endings could be seen near the anastomotic stoma. Within the fourth week after operation, newborn muscle cells became mature and arranged regularly, and contacted each other closely.
Within the first week after the dismembering pyeloplasty, no peristalsis runs through the anastomotic stoma, and the renal pelvic resting pressure increases. Within the second week after the operation, the newborn smooth muscle cells at the anastomotic stoma begin to exercise their contractive and conductive functions. Peristalsis begins to run through the anastomotic stoma. Within the third after the operation, the peristaltic function basically recovers to normal.
研究家兔离断性肾盂成形术后吻合口处蠕动功能的恢复过程。
采用32只新西兰兔制作梗阻性肾积水动物模型。将这些兔分为四组，分别于离断性肾盂成形术后第1、2、3、4周进行检测，每组8只。另取32只正常新西兰兔分为四个相应对照组作为对照。测量肾盂和上段输尿管压力，记录肌电图，并对手术前后吻合口组织进行组织学检查。
正常对照兔肾盂静息压为(10.8±1.3)mmHg，收缩幅度为(1.6±0.4)mmHg，肌电图脉冲幅度为(0.39±0.10)mV，脉冲频率为(5.4±1.0)/min；上段输尿管静息压为(11.7±1.7)mmHg，收缩幅度为(1.8±0.5)mmHg，肌电图脉冲幅度为(0.38±0.08)mV，脉冲频率为(5.3±0.9)/min。术后第1周，肾盂静息压为(14.4±1.3)mmHg，显著高于正常(P<0.05)，肾盂收缩幅度为(1.1±0.4)mmHg，低于正常(P<0.05)；肾盂和上段输尿管肌电图脉冲幅度分别为(0.19±0.05)mV和(0.26±0.04)mV，低于正常(P<0.05)。可见吻合口有一层薄黏膜覆盖。术后第2周，实验组兔肾盂静息压、收缩幅度、肌电图幅度及频率与对照组比较，差异无统计学意义(P>0.05)。可见新生平滑肌细胞穿过吻合口，细胞间紧密接触。术后第3周，肾盂和上段输尿管压力及肌电图与正常兔比较，差异无统计学意义(P>0.05)。可见吻合口附近有神经末梢。术后第4周，新生肌细胞成熟，排列规则，相互紧密接触。
离断性肾盂成形术后第1周，吻合口无蠕动通过，肾盂静息压升高。术后第2周，吻合口新生平滑肌细胞开始发挥收缩和传导功能，蠕动开始通过吻合口。术后第3周，蠕动功能基本恢复正常。
