摘要
目的 :探索反射弧重建膀胱功能的应用解剖和临床疗效。方法 :在 2 0具尸体标本上观察与膝腱反射有关的解剖 ,并应用于 3例患者 ,随访膀胱尿道功能。结果 :L3 脊神经根中的大部分神经纤维贡献给股神经 ,S2～ 4前根与L2～ 4前根相互间均有重叠。L3 ～S3 前根交叉吻接后 2年 ,刺激膝腱可引发膀胱内压升高并在膀胱充盈时引起排尿。结论 :“膝腱 脊髓 膀胱”反射弧重建膀胱功能时宜选用L3 ～S3 前根交叉吻接 ;
Objective:To provide anatomical bases for the operation of bladder functional reconstruction with `knee spinalcord bladder' reflex arc as well as to investigate its clinical application and results.Methods:1.The spinal roots' origin to femoral nerves and L 2～4 and S 2～4 anterior roots' overlaping length,horizontal area and relative position between each other were observed and measured in 20 adult specimens.2.The effect of three SCI patients with L 3～S 3 anterior spinal roots' anastomosis were examined clinically and urodynamically 2 years after operation.Results:1.Femoral nerves is mainly composed of L 3 and L 4 spinal roots,as well the major part of L 2 and L 3 spinal roots contribution to femoral nerves.The level of S 2～4 anterior spinal roots originating from spinal cord is higher than the level of L 2～4 anterior spinal roots running through meninx.2.In all the three patients,stimulation of knee tendon result in an increase of intravescial pressure and cause reflex voiding when the bladder was full filled.Conclusions:1.L 3～S 3 anterior spinal roots cross anastomosis should be taken during the operation of bladder functional reconstruction by the use of knee jerk reflex.2.Establishing `knee spinal cord bladder' reflex arc may be effective for bladder functional reconstruction in SCI and need to be further studied.
出处
《中国矫形外科杂志》
CAS
CSCD
2002年第9期869-871,共3页
Orthopedic Journal of China
基金
国家自然科学基金资助项目 No .30 1 70 956
关键词
脊髓损伤
膀胱功能重建
脊神经前根
应用解剖
神经再支配
Spinal cord reconstruction
Bladder functional reconstruction
Anterior spinal roots
Applied anatomical study
Reinnervation
