Nadelhaft P, Zimmermann A, Bishop M C
Urol Res. 1981;9(4):169-73. doi: 10.1007/BF00264822.
Previous laboratory investigation has indicated that during induction of ischaemia the renal artery should be occluded in preference to the whole pedicle. However, in clinical practice the distinction between these may have only a trivial bearing on subsequent renal function compared with the effect of surgery on the parenchyma. The present work was designed to investigate the effects of pedicle and arterial occlusion on the pig kidney after 90 min of hypothermic ischaemia. However, 2 other groups having nephrotomy were also included to give the study more clinical relevance. The results showed that the combination of nephrotomy and pedicle occlusion gave a significant rise in plasma creatinine in the first 48 h post-operatively compared with the other groups. However, there was no difference between the 4 groups after 8 days and 28 days. Histology of the kidneys removed after 28 days showed comparatively minor changes in terms of glomerular and tubular structural abnormality. Furthermore the vasculature was well preserved though an inflammatory infiltrate was usually found. Semi-quantitative analysis of these changes showed that, paradoxically, they were generally less severe with pedicle than arterial occlusion. Another surprising result of this analysis was that the addition of nephrotomy appeared to be beneficial.
先前的实验室研究表明，在诱导缺血期间，优先阻断肾动脉而非整个肾蒂。然而，在临床实践中，与手术对肾实质的影响相比，这两者之间的区别对后续肾功能的影响可能微不足道。本研究旨在探讨在低温缺血90分钟后，肾蒂阻断和动脉阻断对猪肾脏的影响。然而，另外两组进行了肾切开术，以使研究更具临床相关性。结果显示，与其他组相比，肾切开术和肾蒂阻断联合组在术后48小时内血浆肌酐显著升高。然而，4组在术后8天和28天时并无差异。术后28天切除的肾脏组织学检查显示，肾小球和肾小管结构异常方面的变化相对较小。此外，血管系统保存良好，尽管通常会发现炎性浸润。对这些变化的半定量分析表明，矛盾的是，肾蒂阻断引起的变化通常比动脉阻断引起的变化轻。该分析的另一个惊人结果是，肾切开术的加入似乎是有益的。
