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目的:比较麻醉态与清醒态兔单侧睾丸急性缺血对健侧睾丸血流动力学和病理的影响。方法:42只雄性健康大白兔,随机均分为麻醉组(A)和清醒组(B),各组内再设对照组5只(A0/B0)、不全缺血组8只(A1/B1)、完全缺血组8只(A2/B2)。超声监测下制成单侧睾丸急性缺血模型。缺血组于精索结扎前、后及松解前后相应时间行睾丸超声造影;对照组于相应时间行睾丸超声造影并监测心率、血压。分析两种意识状态下健侧睾丸造影及组织结构变化情况。结果:戊巴比妥钠麻醉后,A组兔心率、血压明显受抑制。单侧睾丸急性缺血后,A组健侧睾丸各造影参数无显著变化;B组健侧睾丸短时间内造影参数峰值基础强度差(PBD)减少,显影时间(AT)、峰值减半时间(HT)延长。精索松解后,A1组、B1组、B2组短时间内PBD增高、HT延长。缺血组健侧睾丸均存在局灶性病理损伤和超微结构变化,但Johnsen’s评分各组无显著差异;A1组、B1组、B2组健侧睾丸凋亡细胞显著增多。结论:急性睾丸血运障碍可对健侧睾丸造成一定程度的损伤。清醒状态下一侧睾丸急性缺血可引起健侧睾丸血流动力学短期内的变化,神经血管反射可能是一重要原因。麻醉剂对兔神经及心血管的抑制作用可使健侧睾丸血流灌注变化不显著。
Objective: To compare the effects of anesthetized and conscious rabbit unilateral testicular acute ischemia on hemodynamics and pathology of contralateral testis. Methods: Forty-two male healthy rabbits were randomly divided into anesthesia group (A) and awake group (B). Five rabbits in control group (A0 / B0) and eight rabbits in incomplete ischemia group ), Complete ischemia group 8 (A2 / B2). Ultrasound monitoring made unilateral testicular acute ischemia model. Testicular contrast echocardiography was performed in the ischemic group before and after spermatic cord ligation and before and after loosening. The control group underwent echocardiography and heart rate and blood pressure monitoring at the corresponding time. Analysis of two conscious states of the contralateral testicular contrast and histological changes. Results: After anesthesia with sodium pentobarbital, heart rate and blood pressure in group A were significantly inhibited. After unilateral testicular acute ischemia, there was no significant change in the parameters of contralateral testis in group A; in group B, the contrastive value of peak basis intensity (PBD), imaging time (AT), peak time in half HT) extended. After spermaticolysis, A1 group, B1 group, B2 group PBD increased in a short time, HT extended. There were focal pathological changes and ultrastructural changes in the contralateral testis of ischemic group, but there was no significant difference in Johnsen’s score between groups. The apoptotic cells in contralateral testis in group A1, group B1 and group B2 were significantly increased. CONCLUSIONS: Acute testicular blood supply disorders can cause some damage to the contralateral testis. Acute ischemia of the testis under awake condition can cause short-term hemodynamic changes in the contralateral testis, and neurovascular reflexes may be an important reason. Anesthetic on rabbit nerve and cardiovascular inhibition can make the contralateral testis blood perfusion did not change significantly.