犬神经原性膀胱模型的建立及尿动力学评价

The canine model of neurogenic bladder and the urodynamics

目的 建立犬神经原性膀胱模型 ,进行尿动力学评价。 方法 8只雌性杂交犬 ,骶上组 4只在第 5～ 6腰椎间孔水平横断脊髓 ,骶下组 4只在此基础上完全破坏骶髓。尿动力学测定模型犬术前及术后 6个月的膀胱容量、逼尿肌压力、膀胱顺应性、尿道压力。 结果 模型犬术后一直存在尾部不能活动和不同程度湿臀的现象 ;弛缓性瘫痪的后肢术后 1周起逐渐恢复 ;下腹部膨胀症状的改善仅见于骶上型犬。骶上组犬术后膀胱容量、顺应性分别下降 37.3%、5 2 .1% ,逼尿肌压力、尿道压力分别增加 33.3%、17.3% ,与术前相比差异均有显著性意义 (P <0 .0 5 ) ;骶下组犬的膀胱容量、顺应性分别上升 89.5 %、78.8% ,与术前和骶上组相比差异均有显著性意义 (P <0 .0 5 )。 结论 在症状及尿动力学方面 ,术后 6个月的犬骶上型和骶下型神经原性膀胱模型均符合脊髓损伤恢复期的膀胱表现 ,两模型适于进行神经原性膀胱的研究。

Objective To develop a canine model of neurogenic bladder and to evaluate it with urodynamics. Methods Eight female dogs were divided into 2 groups:4 in suprasacral and 4 in infrasacral group.The spinal cord was transected at the level of 5th～6th lumbar intervertebra foramen,and sacral cord was kept intact in suprasacral model while in infrasacral model it was destroyed completely.The urodynamic studies were performed in each dog at the time points of preopertation and 6 months postoperation in both groups.The parameters included bladder capacity,detrusor pressure,bladder compliance and urethral pressure. Results The dogs after operation could never move their tails and keep their hips dry.Their hind limbs presented flaccid paralyses and the abdomens dilated during the first postoperative week.Then the mobility of the hind limbs in both groups recovered slowly,but the abdominal signs were improved obviously only in suprasacral dogs.In suprasacral group,bladder capacity and compliance were decreased by 37.3% and 52.1%,respectively, but detrusor pressure (33.3%) and urethral pressure (17.3%) were significantly increased( P <0.05).While bladder capacity (89.5%) and compliance (78.8%) of infrasacral dogs at 6 months after operation were higher than preoperation ( P <0.05). Conclusions The canine neurogenic bladder model shows both clinically and urodynamically the same features as those in the neurogenic bladder after spinal trauma. It can be used as the model in research of neurogenic bladder.