目的 探讨单纯肠系膜损伤的诊断手段及治疗方法。方法 回顾性分析笔者所在医院2009年1月至2011年12月期间收治的12例单纯肠系膜损伤患者的临床资料。结果 12例患者均为腹部闭合性损伤，其中坠落伤2例，车祸伤7例，挤压伤2例，踢打伤1例。均行手术治疗，其中9例系膜破裂出血患者中，3例行系膜血管结扎、系膜修补术，6例行小肠部分切除、系膜修补术；另3例系膜血肿患者均行小肠部分切除术。术后发生切口感染2例，炎性肠梗阻1例，均经对症治疗后好转。其余9例均治愈出院，无并发症发生；无死亡病例。结论 对系膜破裂出血型肠系膜损伤患者应早期行手术治疗，系膜血肿型患者应密切观察病情变化以及做必要的辅助检查，以防止误诊及漏诊。
ObjectiveTo explore the value of Aquaporin-3 (AQP-3) on the detection of early renal function damage by investigating the expressions of renal AQP-3 mRNA and protein of rats with obstructive jaundice (OJ). MethodsForty mature male Wistar rats were divided into two groups randomly: experimental group (n=20) in which the model of OJ rats was established, and control group (n=20, sham operation group). The levels of serum total bilirubin (TBIL), direct bilirubin (DBIL), creatinine (Cr)， and blood urea nitrogen (BUN) were detected by fullautomatic biochemical analyzer on 7 d and 14 d after operation. The expressions of renal AQP-3 mRNA and protein of rats were detected by RT-PCR and Western blotting, respectively. ResultsThe levels of serum TBIL and DBIL were significantly higher on 14 d than those on 7 d after operation in experimental group (P=0.000), which were significantly higher than those at corresponding time point in control group (P=0.000), while the difference within control group was not significant (P=0.154). Thus, the OJ models of rats were established successfully. The difference of serum Cr levels of rats between inter-and intragroup were not significant (Pgt;0.05). Serum BUN level on 14 d after operation in experimental group was significantly higher than those on 7 d after operation in experimental group and on 14 d after operation in control group (P=0.001), although serum Cr levels were not different between 7 d and 14 d after operation in control group (P=0.288). The expressions of AQP-3 protein of rats on 7 d and 14 d after operation in experimental group were significantly lower than those at corresponding time point in control group (P=0.033, P=0.000), meanwhile on 14 d after operation in experimental group was significantly lower than those on 7 d after operation in experimental group (P=0.000). The expressions of AQP-3 mRNA of rats on 7 d and 14 d after operation in experimental group were significantly higher than those at corresponding time point in control group (P=0.000), but the difference at different time point in two groups was not significant (P=0.139, P=0.059). ConclusionsThe changes of renal AQP-3 protein and mRNA expressions are prior to the changes of serum Cr and BUN levels of rats suffered from OJ complicated renal function damage, which are promised to improve the early diagnosis rate of renal function damage in rats with OJ.