脊髓损伤大鼠膀胱功能改变的尿动力学评估

Urodynamic assessment of altered bladder function in rats with spinal cord injury

目的了解大鼠胸腰段、骶髓脊髓背侧损伤后膀胱功能改变的情况,为临床诊断和治疗提供参考依据。方法健康雌性SD大鼠30只,分为3组:①组:胸腰段脊髓损伤12只;②组:骶髓损伤12只;③组:健康对照组6只。造模后记录其每次手法挤压排尿的量,术后第14天行尿流动力学检查,测定其最大膀胱容量,残余尿量和膀胱顺应性。结果在麻醉及脊髓休克期,胸腰段脊髓损伤组和骶髓损伤组动物有尿潴留情况;在脊髓休克恢复期,胸腰段脊髓损伤大鼠表现为低顺应性膀胱,骶髓损伤组表现为高顺应性膀胱。最大膀胱容量增高和残余尿增多的情况在骶髓损伤中更为常见。结论不同部位脊髓损伤后存在膀胱顺应性变化的差异,这可能与部位不同损伤的神经通路差异有关。

Objective To investigate the altered bladder function in rats with injury to thoracolumbar or sacral dorsal spinal cord and to provide evidences for clinical diagnosis and treatment. Methods Thirty healthy female SD rats were divided into three groups, including the Group 1 （thoracolumbar spinal cord injury, n=12）, Group 2 （sacral spinal cord injury, n=12） and Groups 3 （control group, n=6）. After establishment of the spinal cord injury models, urine output achieved by abdomen massage was recorded for each rat. On day 14, all rats underwent urodynamic examination to be assessed for the maximum bladder capacity, residual urine volume and bladder compliance. Results During anesthesia and spinal shock, urinary retention was seen in rats with thoracolumbar or sacral spinal cord injury. While recovering from spinal shock, the rats with thoracolumbar spinal cord injury had hypocompliant and those with sacral spinal cord injury appeared hypercompliant bladders. Increase in maximum bladder capacity and residual urine volume was more common in rats with sacral spinal cord injury. Conclusion The varied alteration in bladder compliance after injury to different sites of the spinal cord may reflect the difference in neural pathways affected.