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泌尿系统损伤临床实用模型的研究

Study of clinical practical model of urinary system injury.

作者信息

Li Gang, Wu Yuan-Yi, Fu Wei-Jun, Jia Ying-Xin, Zhang Bing-Hong, Xu Yong-De, Wang Zhong-Xin, Shi Jian-Guo, Tan Hai-Song, Qian Ye-Yong, Shi Bin-Yi, Zhang Chao-Hua, Wang Xiao-Xiong

机构信息

Department of Urology, Hainan Branch of Chinese PLA General Hospital, Sanya, Hainan 572013, China.

出版信息

Chin Med J (Engl). 2015 Apr 5;128(7):928-32. doi: 10.4103/0366-6999.154299.

Abstract

BACKGROUND

In order to improve the clinical treatment level of urinary system injury, it is necessary to build up an animal model of urinary system wound, which is not only analogous to real clinical practice, but also simple and practical.

METHODS

We have developed the third generation of firearm fragment wound generator based on the first and the second producer. The best explosive charge of the blank cartridge was selected by gradient powder loading experiments. The firearm fragment injuries were made to the bulbous urethra of 10 New Zealand male rabbits. One week preoperatively and 2, 4 and 8 weeks postoperatively, all the animals underwent urethroscopy and urethrography. At 2, 4 and 8 weeks postoperatively, two animals were randomly selected and killed, and the urethra was cut off for pathological examination.

RESULTS

The shooting distance of the third generation of firearm fragment wound generator is 2 cm. The best explosive charge of the blank cartridge is 1 g of nitrocotton. All rabbits survived the procedures and stayed alive until they were killed. Injuries were limited to bulbous urethra and distal urethra. Round damaged areas, 1-1.5 cm in length, on the ventral wall were observed. Ureteroscopy results showed that canal diameter gradually shrank by over 50% in 9 rabbits. The rate of success was 90%. Urethrography result noted that a 1-1.3 cm stricture was formed at the bulbous urethra. Histology results of injured stricture urethra showed that fibrous connective tissue hyperplasia and hyaline degeneration caused further stricture in the canal.

CONCLUSIONS

The third generation of firearm fragment wound generator imitates the bullet firing process and is more accurate and repeatable. The corresponding rabbit model of traumatic complex urethral stricture simulates the real complex clinical conditions. This animal model provides a standardized platform for clinical researches on treating traumatic injuries to the urinary system.

摘要

背景

为提高泌尿系统损伤的临床治疗水平,有必要建立一种泌尿系统创伤动物模型,该模型既要类似于实际临床情况,又要简单实用。

方法

我们在第一代和第二代产品的基础上研发了第三代火器碎片伤发生器。通过梯度装药实验选择了空包弹的最佳装药量。对10只新西兰雄性家兔的球部尿道造成火器碎片伤。术前1周以及术后2周、4周和8周,所有动物均接受尿道镜检查和尿道造影。术后2周、4周和8周,随机选取2只动物处死,切断尿道进行病理检查。

结果

第三代火器碎片伤发生器的射击距离为2 cm。空包弹的最佳装药量为1 g硝化棉。所有兔子手术过程中均存活,直至被处死。损伤仅限于球部尿道和尿道远端。观察到腹侧壁有圆形损伤区域,长度为1 - 1.5 cm。尿道镜检查结果显示,9只兔子的管腔直径逐渐缩小超过50%。成功率为90%。尿道造影结果显示,球部尿道形成了1 - 1.3 cm的狭窄。损伤狭窄尿道的组织学结果显示,纤维结缔组织增生和透明变性导致管腔进一步狭窄。

结论

第三代火器碎片伤发生器模拟子弹发射过程,更精确且可重复。相应的创伤性复杂性尿道狭窄兔模型模拟了真实复杂的临床情况。该动物模型为泌尿系统创伤性损伤的临床研究提供了标准化平台。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/624e/4834010/90b2986c8a45/CMJ-128-928-g001.jpg

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