Köşüm Akın, Borazan Ersin, Maralcan Göktürk, Aytekin Alper
Department of General Surgery, Adıyaman Gölbaşı Hospital, Adıyaman, Turkey.
Department of General Surgery, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.
Ulus Cerrahi Derg. 2013 Jun 1;29(2):49-53. doi: 10.5152/UCD.2013.39. eCollection 2013.
This study aimed to evaluate the effects of experimentally induced intra-abdominal hypertension on renal functions, with the combination of biochemical and histopathological properties.
Thirty male Wistar albino rats were used in this experimental study. Rats were divided into four groups. Group 1 (control group, n=6) only received anesthesia. After the induction of anesthesia, a 20 G catheter was introduced intraperitoneally to Group 2 (sham group, n=8), Group 3 (n=8) and Group 4 (n=8). The intra-abdominal pressure was not increased in Group 2. We applied 20 mmHg intra-peritoneal pressure to Group 3 and 30 mmHg to Group 4 for 3 hours. After withdrawing 3 mL intracardiac blood from all groups, the kidneys were removed for histopathological examination. Serum urea and creatinine levels were measured in all groups.
Biochemical examination showed that blood urea and creatinine levels were statistically different among all groups (p<0.05). Serum creatinine levels in Group 3 and serum urea and creatinine levels in Group 4 were significantly increased. In the histopathological examination, the kidneys in Group 1 and Group 2 were classified as normal. In Group 3, areas with congestion were detected in the glomeruli and interstitial regions. In addition to these findings seen in Group 3, dilatation of the pelvi-caliceal structures and proximal ureters were noticed in Group 4.
The levels of serum urea and creatinine are elevated when intra-abdominal pressure is increased due to kidney damage. Foci of hemorrhage in the interstitial area, dilatations in the proximal ureter, renal pelvis, and lymphatics were the pathologic findings seen in the kidneys under such circumstances.
本研究旨在结合生化和组织病理学特性,评估实验性诱导的腹腔内高压对肾功能的影响。
本实验研究使用了30只雄性Wistar白化大鼠。大鼠被分为四组。第1组(对照组,n = 6)仅接受麻醉。麻醉诱导后,将一根20G导管经腹腔插入第2组(假手术组,n = 8)、第3组(n = 8)和第4组(n = 8)。第2组腹腔内压力未升高。我们对第3组施加20 mmHg的腹腔内压力,对第4组施加30 mmHg的腹腔内压力,持续3小时。从所有组中抽取3 mL心内血后,取出肾脏进行组织病理学检查。测量所有组的血清尿素和肌酐水平。
生化检查显示,所有组之间血尿素和肌酐水平存在统计学差异(p < 0.05)。第3组的血清肌酐水平以及第4组的血清尿素和肌酐水平显著升高。在组织病理学检查中,第1组和第2组的肾脏分类为正常。第3组在肾小球和间质区域检测到充血区域。除了第3组出现的这些发现外,第4组还注意到肾盂-肾盏结构和近端输尿管扩张。
由于肾脏损伤,腹腔内压力升高时血清尿素和肌酐水平会升高。间质区域的出血灶、近端输尿管、肾盂和淋巴管的扩张是在这种情况下肾脏出现的病理表现。