大鼠脊髓不同平面损伤后神经源性膀胱模型的尿流动力学检查

Urodynamic study of neurogenic bladder model after spinal cord injury in rat

目的观察大鼠不同平面脊髓损伤(SCI)后尿流动力学的改变,探讨不同平面SCI引起神经源性膀胱的病理生理机制。方法选择健康雌性SD大鼠80只,分为骶上脊髓(胸腰段)损伤组(30只)、骶髓损伤组(30只)及对照组(20只)。采用脊髓横断法制备大鼠脊髓不同平面损伤后神经源性膀胱模型。分别于动物模型制作前及制作后第20天行尿流动力学检查,评价大鼠的膀胱功能。结果骶上脊髓损伤组逼尿肌漏尿点压较对照组、骶髓损伤组明显升高,差异有统计学意义(P<0.01),骶髓损伤组逼尿肌漏尿点压较对照组显著降低,差异有统计学意义(P<0.01);骶上脊髓损伤组膀胱最大容量、膀胱顺应性较对照组、骶髓损伤组明显降低,差异有统计学意义(P<0.01),骶髓损伤组膀胱最大容量、膀胱顺应性较对照组显著增加,差异有统计学意义(P<0.01)。结论尿流动力学检查为神经源性膀胱的早期诊断及选择个体化治疗方案提供了一种有效的检查手段。

Objective To observe the urodynamic change after spinal cord injury at different levels and the relationship with neurogenic dysfunction of bladder and urethra. Methods Eighty female rats were divided into a control group （20 rats） , a suprasacral spinal cord injury group （30 rats） and a sacral spinal cord injury （ 30 rats）. The urodynamic exam was performed with all the rats before and 20 days after the spinal cord injury model was established by surgical operation. Results The maximum bladder volume and compliance in the suprasacral injury group were significantly less than the sacral spinal cord injury group and the control, the maximum volume and compliance in sacral spinal cord injury group were significantly less than the control. The DLPP in suprasacral injury group was significantly higher than that in the sacral spinal cord injury group and the control, the DLPP in sacral spinal cord injury group was significantly less than that in the control group. Conclusion Urodynamic study is very useful for the early diagnosis and individualized treatment of the neurogenic bladder after spinal cord injury.