骶神经根电刺激对脊髓损伤后兔膀胱功能的影响研究

Influence of Bladder Function for Rabbit Model with Supersacral Spinal Cord Injury Using Sacral Root Nerve Stimulation.

目的:探讨骶神经根电刺激对骶上脊髓损伤后兔模型膀胱功能的影响。方法:20只实验兔,通过手术方法制作骶上脊髓损伤模型,术前术后尿流动力学比较。首次骶神经根电刺激和刺激1周后再次尿流动力学观察,与刺激前进行对照。结果:20只实验兔中术后死亡3只,余均表现有不同程度下肢瘫痪及大小便功能障碍。尿流动力学表现为膀胱容量减小;膀胱静息压上升,顺应性下降;逼尿肌无抑制收缩增多,表现为逼尿肌反射亢进。最大逼尿肌压和膀胱漏点压上升。刺激一周后测压结果显示膀胱容量明显上升,膀胱顺应性上升,灌注期压力上升平稳,无抑制收缩活动减少,最大逼尿肌压下降,膀胱漏点压下降不明显。骶神经根电刺激过程中同步尿流动力学检测结果与刺激前无明显差异。结论:单次骶神经根电刺激对脊髓损伤兔膀胱功能影响不明显,而长期刺激可以明显抑制逼尿肌异常活动,改善储尿功能。

Objective： To evaluation the Results of bladder function for rabbit model with supersacral spinal cord injury using sacral root nerve stimulation. Methods： 20 rabbit models were done by operation. Urodynamic studies were carried pre- and post-operation. And the same studies were carried at the time of sacral root nerve stimulation and after one week continuous stimulation. Results： The urodynamic characters of animal models were decreasing of bladder volume; increasing of bladder resting pressure; decreasing of bladder compliance; increasing of inhabited contraction. These presented as detrusor hyperreflexia. After one week stimulation , the bladder volume and bladder compliance increased significantly. The inhabited contraction and maximum detrusor pressure were decreased. There was no significant difference before and at the time of stimulation. Conclusion： The single time stimulation has no significant effect on bladder function. But continuous stimulation may have strong effect to inhabit abnormal activity of detrusor and improve storing function.