前列腺癌根治术后尿失禁动物模型的建立和稳定性评估

Evaluation of Establishment and Stability in Radical Prostatectomy Urinary Incontinence Models

目的通过评估前列腺癌根治术后尿失禁动物模型的稳定性,为进一步研究电针治疗尿失禁的控尿机制提供稳定模型依据。方法采用尿道括约肌电灼伤法建立前列腺癌根治术后尿失禁动物模型,通过观察模型大鼠喷嚏试验阳性率、尿道括约肌组织形态学变化和尿动力检测进行模型评估。结果模型组喷嚏试验阳性率为57.14%;通过Masson染色可知空白组和假手术组动物尿道结构完整,尿道括约肌肌纤维结构排列紧密整齐,无充血及炎性渗出,而模型组尿道外括约肌肌纤维排列结构疏松紊乱,部分细胞间质炎性渗出伴血肿和结缔组织增生,符合尿道括约肌损伤表现;通过尿动力学检测发现,组内比较模型组在造模后第10天的最大膀胱容量和漏尿点压低于造模前(P<0.017),而造模后第17天与第3天差异无统计学意义(P>0.017);组间比较发现模型组在造模后第10天的最大膀胱容量和漏尿点压与假手术组相比差异有统计学意义(P<0.017);空白组和假手术组造模前后膀胱最大容量和漏尿点压组间和组内比较均无统计学差异(P>0.017)。结论尿道括约肌电灼伤法可以成功建立前列腺癌根治术后尿失禁动物模型,该模型符合术后尿失禁患者临床表现和体征。模型建立后3-7天稳定性较高,适用于研究电针控尿机制,14天后出现自愈倾向,可能会影响电针疗效的判定。

Objective To study the urinary control mechanism of electroacupuncture in the treatment of urinary incontinence and provide experimental basis for further study by evaluating the stability of the animal model of radical prostatectomy urinary incontinence(RPUI)and investigating the objective,scientific and simple evaluations.Methods Electrocautery of the urethral sphincter was carried out for the modeling of RPUI.The rat models were evaluated by observing the results of sneeze test,histological changes of urethral sphincter and urine dynamic test.Results In model group,the positive rate of sneezing test was 57.14%;The urethral structure was complete and urethral sphincter muscle fiber structure closely packed neatly,no congestion and inflammatory exudation in the blank and the control group by Masson staining.Although the urethral sphincter muscle fiber arrangement structure loose disorder,some intercellular substance had inflammatory exudation,hematoma and connective tissue hyperplasia in the model group;All these performances conformed to the damage of urethral sphincter.Urodynamic test showed that the maximum bladder capacity and leak point pressure of the model group were lower than those before modeling on the 10thday after modeling(P<0.017),but there was no significant difference between the 17thday after modeling and the 3rdday(P>0.017).The results showed that the maximum bladder capacity and leak point pressure in the model group were significantly different from those in the sham group(P<0.017).There were no significant differences in the maximum bladder volume and urine leakage point pressure before and after modeling between the blank group and the sham group(P>0.017).Conclusion Electrocautery of the urethral sphincter can establish the rat models of RPUI successfully,which is consistent with the clinical manifestations of patients with postoperative urinary incontinence.The rat models have high stability for 3-7 days after model operation,which is suitable for studying the mechanism of urine control by electroacupuncture.After 14 days,the self-healing tendency appears,which may affect the judgment of acupuncture efficacy.