利用端侧神经吻合方法建立人工体神经-内脏神经反射弧的实验研究

Study on end-to-side neurorrhaphy connecting autonomic nerve to somatic nerve for restoring bladder function in rats

目的探讨利用端侧神经吻合方法建立人工反射弧来重建膀胱功能的可行性。方法取SPF级雄性SD大鼠20只,分为2组:①端端吻合组:在椎管内分别离断左侧L4(LL4)前根和L6(LL6)前根,将LL4前根中枢段断端与LL6前根外周段断端行端端吻合,共10只;②端侧吻合组:在椎管内离断左侧L6前根,将LL6前根外周段断端与LL4前根行端侧吻合,共10只;手术6个月后电刺激吻合口近端测定各组大鼠的最大膀胱收缩压力,并对再生有髓神经纤维计数进行比较。结果端侧吻合组大鼠的膀胱最大收缩压力与再生有髓神经纤维计数均明显低于端端吻合组(P<0.01)。结论利用端侧神经吻合方法建立人工反射弧来重建膀胱功能效果不佳,不能替代原手术方法。

[ Objective ] To investigate the feasibility of establish an artificial somatic-autonomic reflex arc with end-to-side neurorrhaphy for restoring bladder function in rats. [ Methods ] 20 SD rats were randomly divided into 2 groups： group A and group B. In group A of 10 rats, the artificial somatic-autonomic reflex pathway was estab- lished by micro-anastomosis of left L4 ventral root （VR） to L6 VR; in group B of 10 rats, the left L6 VR was sec- tioned and the distal end was sutured laterally to the intact left L4 VR. Electrophysiological and histological assess- ments for nerve regeneration were performed 6 months postoperatively. [ Results ] The bladder detrusor contraction of group A was very weaker, and the counts of regenerated nerve axons also showed that a significant difference existed between the two groups （P 〈0.01）. [ Conclusion] End-to-side neurorrhaphy is not satisfactory to establish an artifi- cial somatic-autonomic reflex arc for restoring bladder function in rats.