利用腹壁反射建立人工膀胱反射弧的实验形态学研究

EXPERIMENTAL MORPHOLOGIC STUDY ON THE ARTIFICIAL BLADDER REFLEX ARC ESTABLISHED BY ABDOMINAL REFLEX AFTER SPINAL CORDINJURY

研究利用腹壁反射建立“腹壁反射 脊髓中枢 膀胱”人工膀胱反射弧的神经形态学基础。将SD大鼠右侧T13 前根近端与右侧S2 前根远端通过一段自体移植神经在硬膜囊内行显微缝合 ,保持T13 后根完整 ,同时切断实验侧L5～S4脊神经前根 ,经 3～ 4个月轴突再生后 ,建立“腹壁反射 脊髓中枢 膀胱”这一新的人工膀胱反射弧。神经缝合术后 8个月 ,对该反射弧进行神经形态学观察。光镜下观察 ,T13 前根再生的神经纤维已通过T13 与S2 神经远端缝合部 ;电镜下观察 ,实验侧膀胱平滑肌内可见到副交感神经末梢 ,其基本结构与对照侧类似 ,而在阴性对照组未发现有正常结构的副交感神经末梢。本实验结果表明 ,腰骶髓截瘫平面以上的躯体运动神经轴突长入膀胱平滑肌内副交感神经节细胞 ,并由此将异化的躯体反射冲动传递到其支配的膀胱平滑肌细胞 ,是人工反射弧产生膀胱控制性排尿的神经形态学基础。

To study the neural morphological basis of the 'abdominal reflex spinal cord center bladder' artificial bladder reflex arc established by abdominal reflex. It is achieved by intradural microanastomosis of the right T 13 ventral root was anastomosed under microscope to S 2 ventral root by autogenous nerve grafting intraduraly, with the right T 13 dorsal root remaining intact and the right L 5 ～S 4 ventral roots severed. three to four months were allowed to achieve axonal regeneration, and new 'abdominal reflex spinal cord center bladder' artificial bladder reflex pathway was established. Eight months after the operation, it was seen under light microscopy that regenerative nerve fibers of ventral root of T 12 had grown through the anastomotic site to distal nerve root. Under electron microscopy, nerve endings in the detrusor of the bladder were seen on the experimental side. The basic structure of the junction between parasympathetic nerve endings and bladder detrusor cells on the experimental side was similar to that on the control side. These features were not seen in the control group. The results suggested that the somatic motor axons above the lumbosacral paraplegia level could innervate bladder parasympathetic ganglion cells, and thereby transfersed somatic reflex activity to the bladder detrusor muscle, which was the morphological basis of the artificial bladder reflex arc leading to controllable micturition