不同骶神经根对膀胱逼尿肌的支配作用及临床意义

Innervation to bladder detrusor of different sacral roots and its clinical significance

目的 :确定不同骶神经根对膀胱的支配频率和支配效能。方法 :总结在 10例圆锥上脊髓损伤患者 ,从马尾骶神经根途径进行膀胱功能重建时术中骶神经根电刺激的膀胱测压结果。结果 :对膀胱的支配频率 ,S3 占 10 0 % ,S4占 90 % ,S2 占 2 5 % ;对膀胱的支配效能 ,S3 占 5 2 .2 % ,S4占 44 .9% ,S2 占 2 .5 %。 (S3 +S4)提供了膀胱压力的 97% ,S2 无论在支配频率和支配效能方面 ,作用均很小。结论 :膀胱逼尿肌的神经支配主要由S3 和S4提供。

Objective:To determine the frequency and efficacy of differential sacral roots innervation to bladder detrusor.Methods:Ten cases of complete supraconal spinal cord injury patients were included.Intraoperative electrical stimulation of each individual S 2～S 4 root was carried out and the increase of bladder pressure was recorded.Results:S 3 root was the most frequent (100%) and the most efficacious (52.2%) contributor, S 4 was the second frequent (90%) and a leser but still significant efficacious (44.9%) one, and S 2 was the lest frequent (25%) and the minimal (2.9%) efficacious contributor.The right roots seemed to be stronger than the left ones.Conclusions: The parasympathetic innervation to bladder detrusor in Asians is mainly provided by S 3 and S 4 roots.Its clinical implication should be discussed in detail.