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目的 利用截瘫平面以上的腹壁反射通路建立SD大鼠的人工膀胱反射弧 ,以恢复脊髓损伤 (SCI)后可控制性膀胱排尿功能。它包含了一个皮肤反射弧 (下腹壁反射弧 ) ,并将皮肤反射的运动冲动传入膀胱 ,引起膀胱的自主性收缩。 方法 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 ,经一段时间轴突再生后 ,建立“腹壁反射 脊髓中枢 膀胱”这一新的人工膀胱反射弧。通过刺激右侧下腹壁反射激发截瘫动物排尿。神经缝合术后 8个月 ,在破坏L5～S4脊髓节段前后 ,分别进行神经电生理、膀胱测压和神经药理学实验等远期功能观察。 结果 在破坏L5～S4脊髓节段造成截瘫前后 ,单相方波 (3mA ,0 3ms)刺激实验测T13 后根 ,12只SD大鼠的实验侧膀胱神经丛可记录到动作电位 ,其形态和波幅与对照组相似 ;串刺激 (3mA ,2 0Hz ,5s)实验侧T13 后根 ,经新建的膀胱人工反射弧引出膀胱平均内压达对照侧的 76% ,膀胱平滑肌复合肌肉动作电位平均最大波幅达对照侧 81% ,波形与对照组相似。在膀胱平滑肌内注射阿托品 (0 0 5mg/kg)或三甲噻酚 (5mg/kg)可抑制通过该人工反射弧激发的膀胱平滑肌收缩功能 ,而膀胱平滑肌内注射维库溴铵 (4mg/kg)对膀胱平滑肌收缩功能无影响。?
Objective To establish an artificial bladder reflex arc of SD rats by using the abdominal reflex path above the plane of paraplegia so as to restore the controllable urinary bladder function after spinal cord injury (SCI). It contains a skin reflex arc (lower abdomen reflex arc), and the movement of the skin reflects the impulse into the bladder, causing the voluntary contraction of the bladder. Methods The proximal right T13 anterior root and right anterior root S2 of SD rats were sutured slightly by dural autograft in the dural sac to maintain the integrity of T13 posterior roots. After a period of axon regeneration, Abdominal wall reflex spinal cord central bladder "This new artificial bladder reflex arc. Paralysis of animals was stimulated to urinate by stimulating the right lower abdominal wall. Eight months after the nerve suture, long-term functional observation such as neuroelectrophysiology, bladder manometry and neuropsychological tests were performed before and after destroying the spinal cord segments of L5 to S4. Results Before and after paraplegia caused by the destruction of the spinal cord segments from L5 to S4, the posterior root of T13 and the experimental side of the bladder plexus of 12 SD rats were measured by single phase square wave (3mA, 0 3ms) (3mA, 20Hz, 5s) experimental side of the T13 posterior root, the bladder artificial reflection arc induced bladder average internal pressure of 76% of the control side, the average muscle smooth muscle smooth muscle action potential average maximum amplitude 81% of the control side, the waveform similar to the control group. Intravesical instillation of atropine (0.05 mg / kg) or trimethophenol (5 mg / kg) suppressed bladder smooth muscle contractile function stimulated by the artificial reflex arc while intravesical instillation of vecuronium (4 mg / kg) No effect on contractile function of bladder smooth muscle. ?