下尿路神经控制的研究进展

Research Progress on Nerve Control of Lower Urinary Tract

尿液的储存与排空是通过膀胱和尿道的高度协调活动完成的,排尿过程中膀胱逼尿肌收缩,尿道和尿道括约肌相应协调地舒张,同时有传入神经、脊髓、大脑、传出神经等多种神经及生理反射共同参与此过程。由于膀胱功能的控制由交感神经、副交感神经、自主神经及多个中枢神经部位共同参与完成,且排尿和储尿过程需要多个神经控制协调进行,整个过程非常复杂,因此神经损伤后临床症状也会多种多样,为便于理解神经源性膀胱的不同临床症状及治疗机制,现对下尿路的神经控制综述如下。

The function of bladder urine storage and voiding owes to the highly coordinated activities of the bladder and urethra,in the process of voiding,the bladder detrusor contracts and the urethra and urethral sphincter relaxes in a coordinated manner.At the same time,afferent nerves,spinal cord,brain,efferent nerves and other nerves and physiological reflexes participate in this process.There are sympathetic nerve,parasympathetic nerve,autonomic nerve and multiple central nervous participate in bladder function control of micturition and urinary storage,which is a very complex process requires coordinate multiple neural control.Therefore,the clinical symptoms after nerve injury are also varied.In order to understand the different clinical symptoms and treatment mechanisms of neurogenic bladder,the neural control of the lower urinary tract is summarized as follows.