大鼠脊髓全横断损伤后神经源性膀胱模型的建立及评估

Establishment and Evaluation of Rat Model of Neurogenic Bladder after Spinal Cord Transection Injury

目的建立理想的脊髓损伤（SCI）后神经源性膀胱（NB）动物模型并评估脊髓及膀胱状态。方法16只SD大鼠分为对照组（假手术）6只，实验组（T9脊髓全横断损伤大鼠模型）10只，记录每日实验组大鼠手法排尿量等情况以评估SCI后NB恢复情况，术后2周使用尿流动力学方法检测并比较两组大鼠膀胱内压以评估大鼠膀胱状态。结果实验组大鼠术后1d、5d、10d、13d、14d时尿量均明显高于对照组大鼠（P〈0．05），术后16d实验组大鼠尿量与对照组无差异（P〉0．05）。术后一周内，大鼠手法辅助排尿量逐渐增加并达到最大。术后一周后，大鼠辅助排尿量逐渐减低并于两周时渐渐稳定。对照组及实验组大鼠在最大膀胱压、膀胱基础压、排尿阈、收缩间隔、膀胱容量、排尿效率的参数值分别为26．60±4．31mmH20、21．66±2．56mmH20；11．66±1．33mmH20、14．72±2．65mmH20；20．46±0．52mmH20、16．99±0．81mmH20；1．36±1．58min、2．02±0．36min；0．82±0．15mL、2．20±0．24mL；92．67％±1．97％、25．33％±4．46％，差异均具有统计学意义（P〈0．05）。结论采用T9水平脊髓全横断损伤制作的NB大鼠模型可操作性强，易量化、可重复，在正确积极的术后护理下并发症少、死亡率低。使用术后SCI大鼠手法排尿量的变化判断脊髓恢复情况，并以尿流动力学方法检测大鼠在膀胱连续灌注下的膀胱压力变化来评价其膀胱状态客观可行。

Objective To establish the ideal animal model of neurogenic bladder （NB） after spinal cord injury （SCI） and evaluate and the state of the bladder. Methods Sixteen female SD rats were divided into control group and the experimental group （T9 spinal cord transection injury model）, accord- ing to the record of the dally manual urination output to evaluate the NB recovery after SCI. After two weeks the simultaneous recording of the intravesical pressure were used to detect, compare and assess the state of bladders in two groups. Results The urine output of experimental rats at first day, 5~h day, 10~ day, 13th day, 14th day after operation were significantly higher than thoes of control group rats （P〈0.05）, and the urine output of experimental rats at 16th day after operation was no statistically significant differ- ence with control group （P〉0.05）. During a week postoperation, the daily manual urination output increased and reached maximum. One week later postoperation, the dally manual urination output was on the gradually decrease and stable for two weeks. The values of the parameters of the maximum bladder pressure, the basis bladder pressure, voiding threshold, bladder capacity, voiding efficiency in control group and experimental group respectively were 26.60 ± 4.31 mmH20 and 21.66±2.56 mmH2O, 11.66±2.33 mmH20 and 14.72 ± 2.56 mmH20, 20.46±0.52 mmH20 and 16.99± 0.81 mmH20, 1.36 ± 1.58 min and 2.02 ±0.36 min, 0.82 ± 0.15 mL and 2.20±0.24 mL, 92.67% ± 1.97% and 25.33% ± 4.46%, the differences were statistically significant （P〈0.05）. Conclusion The NB rat model of T9 level spinal cord transection injury with a strong maneuverability and easy to quantify, repeatable. With the correct postoperative nursing care, there were fewer complications and low mortality. The recording of daily manual urination output and the intravesical pressure can be the good ways to detect the spinal cord recovery and evaluate the status of the bladder.