摘要
目的 探讨脊髓损伤后膀胱完全性去神经传入手术的替代方法。方法 健康杂种犬 16只经 T1 0平面截瘫后 ,按 L7～ S3神经根切断程度的不同 ,从完全保留到完全切断分成六组 ,比较术中神经根 (总根和后根 )电刺激时的膀胱尿道压力变化和术后膀胱压力容积曲线 (CMG)变化。结果 1电刺激研究 :犬膀胱的神经支配以 S2为主 ,S1 次之 ;尿道的神经支配以 S1 为主 ,S2 次之。在保留 S1 或 S2 前后根完整的情况下 ,刺激同平面 S1 或 S2 的总根或后根 ,膀胱尿道的压力反应相同 ;切断 S1 或 S2 前根 ,刺激同平面的 S1 或 S2 后根 ,膀胱尿道的压力反应显著降低。 2 CMG研究 :保留同一平面 S1 或 S2 前后根的完整 ,其 CMG曲线与完全不切断的对照组相似 ,形成痉挛性膀胱。不保留同一平面前后根的完整 ,即切断 S1 或 S2 前根 ,其 CMG曲线与切断全部后根的对照组相似 ,形成弛缓性膀胱。结论 不同平面的骶神经前后根组合切断 。
Objective To investigate an alternative procedure for complete denervation of bladder in the supra-cone cord injury to restore the bladder function. Methods Sixteen dogs were included in this study after their spinal cords were transected above the cone. They were divided into 6 groups and performed the rhizotomy of L 7 to S 3 root in different combination respectively. The bladder and urethra pressure change by electrostimulation during operation and cystometrogram change after operation were tested. Results ①Electrostimulation study: for bladder innervation, S 2 was the most important and S 1 was secondary. While for urethra innervation, S 1 was more important than S 2. When the anterior and posterior roots of S 1 and S 2 were intact with rhizotomy of posterior roots of L 7 and S 3, stimulated the common or posterior root of S 1 and S 2, the change of pressure in bladder and urethra was the same. When the anterior roots of S 1 and S 2 were resected with rhizotomy of posterior roots of L 7 and S 3, the pressure in bladder and urethra was significant decreased compared to stimulating the corresponding posterior roots. ② Cystometrogram (CMG) study: in the complete deafferented group, resecting the posterior roots of L 7 to S 3, the bladder became flaccid. While resecting the posterior root of S 2 and anterior root of S 1 or, resecting the posterior root of S 1 and anterior root of S 2, combining with rhizotomy of posterior roots of L 7 and S 3, the CMG curve was similar to the complete deafferented group. In the S 1 and S 2 intact group, the bladder became spastic. Conclusion Combining rhizotomy of anterior and posterior sacral root in different level has the same effects on bladder as complete deafferentation.
出处
《中国修复重建外科杂志》
CAS
CSCD
2001年第2期69-73,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
脊髓损伤
骶神经根切断
膀胱去神经
电刺激排尿
尿失禁
膀胱功能
Spinal cord injury Sacral root rhizotomy Bladder denervation Electrostimulation micturition Urinary incontinence
