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The optimal selective perfusion flow rate of kidney during thoracoabdominal aortic aneurysm surgery : an experimental analysis in dogs.

胸腹主动脉瘤手术中肾脏最佳选择性灌注流量：犬实验分析。

基本信息

批准号：
08457352
负责人：
KOJA Kageharu
金额：
$ 4.29万
依托单位：
Second department of surgery, faculty of medicine, University of the Ryukyus.
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1997
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08457352/
关键词：
selective perfusin thoracoabdominal aneurysm ATP renal ischemia inorganic phosphorus actic acid viability

项目摘要

Object : Selective perfusion (SP) of the visceral arteries is a useful adjunctive method for the prevention of organic ischemia during thoracoabdominal aneurysm surgery. However, the appropriate perfusion flow rate is unclear. The present study attempts to characterize the changes seen in the kidney associated with various perfusion flow rates. Method : 28 dogs underwent laparotomy and both kidneys were exposed. A cannula delivering perfusate was introduced in to the left renal artery. The kidney was perfused selectively with normothermic blood for 2 hrs and then returned to normal circulation for 2 hrs. The contralateral kidney served as a control. ATP,inorganic phosphorus (IP) and lactic acid (LA) of the renal cortex were measured. The perfused kidneys were classified into the following 4 groups according to perfusion flow rate.Group 1 (G1) : perfusion flow 10% of native renal blood flow. Group 2 (G2) : 25%. Group 3 (G3) : 50%. Group 4 (G4) : 100%. Results : There was a significant difference in ATP content between G1, G2 and the control group after 2 hrs SP.However, the ATP content was restored in G2 after 2hrs reperfusion. No significant difference was observed in G3 and G4. The level of IP and LA increased significantly in G1 after SP and then decreased after reperfusion. Morphological change was slight in G2, and more pronounced in G1 and G4. During SP,mean renal artery pressure exceed 200 mmHg in G4. Conclusion : The renal function was maintained to almost normal in G3, whereas reversable improvement of renal function was seen in G2.

对象：内脏动脉选择性灌注（SP）是预防胸腹部动脉瘤术中器质性缺血的有效方法。然而，适当的灌注流速尚不清楚。本研究试图描述与各种灌注流速相关的肾脏变化。方法：对28只狗进行剖腹手术，暴露双肾。将输送灌注液的插管引入左肾动脉。用正常体温血液选择性灌注肾脏2小时，然后恢复正常循环2小时。对侧肾脏作为对照。测定肾皮质ATP、无机磷（IP）和乳酸（LA）含量。根据灌注流量的不同将灌注肾分为4组：第1组（G1）：灌注流量为自体肾血流量的10%。第2组（G2）：25%。第3组（G3）：50%。第4组（G4）：100%。结果如下：G1、G2组SP后2h ATP含量与对照组相比有显著性差异，G2组再灌注2h ATP含量恢复正常。在G3和G4中未观察到显著差异。IP和LA水平在SP后G1显著升高，再灌注后下降。形态学变化在G2中轻微，在G1和G4中更明显。在SP期间，G4的平均肾动脉压超过200 mmHg。结论：G3期肾功能基本维持正常，G2期肾功能可逆转性改善。