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目的:评价钬激光对膀胱黏膜破坏作用,探讨钬激光误伤膀胱黏膜后治疗办法。方法:根据是否接受钬激光烧灼和术后静注地塞米松,将实验鼠分为三组:对照组、钬+生组和钬+地组。通过建立钬激光灼伤大鼠膀胱黏膜模型,观察被钬激光灼伤后其髓过氧化氢酶(MPO)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)活性、丙二醛(MDA)的含量以及血管生长、移行上皮组织形态、上皮细胞凋亡指数的改变。结果:光镜下对照组的膀胱壁各层少许炎性细胞浸润;钬+生组膀胱壁黏膜层和肌层内小血管充血明显,大量炎性细胞浸润。部分黏膜层已脱落,脱落处炎症表现较重;钬+地组膀胱各层小血管充血明显,较多炎性细胞浸润;钬+生组膀胱壁各层大量移行上皮细胞凋亡,对照组、钬+地组膀胱各层部分移行上皮细胞凋亡,但凋亡程度均较钬+生组轻;钬+地组BvC(P<0.01)、BvSAP(P<0.05)、BvSAD(P<0.05)及AI(P<0.01)与对照组、钬+生组相应值对比差异有统计学意义;钬+生组MPO活力、CAT活力和MDA含量与钬+地组相比差异有统计学意义(P<0.01);SOD活力与钬+地组相比差异有统计学意义(P<0.05)。结论:钬激光烧灼对膀胱黏膜上皮细胞有破坏作用。糖皮质激素可以减轻这种破坏作用。
Objective: To evaluate the effect of holmium laser on bladder mucosa destruction and to explore the treatment of bladder mucosa after holmium laser accidental injury. Methods: The experimental rats were divided into three groups: control group, holmium + group and holmium + group according to whether holmium laser was cauterized and dexamethasone was given intravenously or not. The model of bladder mucosa was induced by holmium laser in rats. The activities of MPO, CAT, SOD and malondialdehyde (MDA) were observed after burned with holmium laser. ) Content and vascular growth, transitional epithelium morphology, epithelial cell apoptosis index changes. Results: Under the light microscope, there was a little infiltration of inflammatory cells in the bladder wall; the small blood vessels in the mucosal layer and muscular layer of the holmium + group were obviously infiltrated, and a large number of inflammatory cells infiltrated. Part of the mucosal layer has shed, off the inflammation of the performance of heavier; holmium + ground group of small blood vessels in the bladder congestion, more inflammatory cell infiltration; holmium + bladder group of bladder layers of a large number of epithelial cell apoptosis, the control group, In the holmium group, the levels of BvC (P <0.01), BvSAP (P <0.05), BvSAD (P <0.05) And AI (P <0.01), but there was significant difference between holmium + group and holmium + group (P <0.01). There was significant difference between MPO activity, CAT activity and MDA content in holmium + <0.01). There was significant difference in SOD activity between the two groups (P <0.05). Conclusion: Holmium laser cauterization of bladder mucosal epithelial cells have a damaging effect. Glucocorticoids can reduce this damaging effect.