Harrison M R, Ross N, Noall R, de Lorimier A A
J Pediatr Surg. 1983 Jun;18(3):247-56. doi: 10.1016/s0022-3468(83)80094-3.
In an attempt to simulate congenital hydronephrosis secondary to urethral obstruction, we evaluated the consequences of obstructing the urethra in fetal lambs by several techniques. When the urethra was ligated before 108 days gestation, the bladder decompressed through the urachus and the upper-urinary tract developed normally. Ligation of both the urethra and urachus produced gross bilateral hydronephrosis, hydroureter, and megacystis, as well as severe pulmonary hypoplasia, and was associated with a high perinatal mortality. Intermittent urethral obstruction produced with a balloon constrictor or by diverting urine externally and pressure-limited obstruction produced with a Pudenz valve both proved unsatisfactory for producing congenital hydronephrosis. Finally, ligation of the urachus and progressive gradual obstruction of the urethra with an ameroid constrictor produced hydronephrosis and pulmonary hypoplasia. This model simulates urethral obstruction in the human fetus and produces a clinical and pathologic picture similar to that seen in infants born with congenital hydronephrosis.
为了模拟继发于尿道梗阻的先天性肾积水，我们通过几种技术评估了在胎羊中阻塞尿道的后果。当在妊娠108天之前结扎尿道时，膀胱通过脐尿管减压，上尿路正常发育。尿道和脐尿管均结扎会导致双侧严重肾积水、输尿管积水、巨大膀胱，以及严重的肺发育不全，并伴有高围产期死亡率。用球囊收缩器间歇性阻塞尿道或通过外部引流尿液以及用普登兹瓣膜进行压力限制阻塞，对于产生先天性肾积水均被证明是不理想的。最后，结扎脐尿管并用阿梅罗伊德收缩器逐渐渐进性阻塞尿道会导致肾积水和肺发育不全。该模型模拟了人类胎儿的尿道梗阻，并产生了与先天性肾积水患儿相似的临床和病理表现。
