先天性肛门直肠畸形胎鼠腰骶髓副交感神经元发育异常的研究  

Quantitative analysis of the rectal parasympathetic neurons in rats with anorectal malformation

作　　者：贾慧敏[1] 王维林[1] 袁正伟[1] 白玉作[1] 

机构地区：[1]中国医科大学第二临床学院小儿外科,沈阳110004

出　　处：《中华小儿外科杂志》2004年第3期279-281,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　探讨先天性肛门直肠畸形是否同时存在副交感神经支配异常以及对术后排便功能的影响。方法　 2 0只Wistar孕鼠 ,分为ETU致畸组 (15只 )和对照组 (5只 )。孕 2 0d时 ,将荧光金注射入正常胎鼠直肠壁及畸形胎鼠的直肠盲端肌层内。荧光显微镜下观察副交感神经元的数量 ,形态和分布。结果　①致畸组胎鼠手术存活率为 6 0 .0 % ,而对照组存活率为 71.4 % ;②对照组 :荧光金标记的副交感神经元位于脊髓侧角 ,分布在L6到S1脊髓节段 ,标记神经元数量为 (90 1± 4 6 )个。神经元体积较大。ETU致畸组中外观正常组、低位畸形组、高位畸形组标记神经元数量分别为 (899± 36个 )、(5 88± 10 2 )个和 (2 4 2± 92 )个 ,畸形组与正常组、外观正常组相比 ,统计学差异显著 ,而且神经元细胞体积明显减小。结论　①先天性肛门直肠畸形胎鼠骶髓副交感神经元数目减少 ,体积减小 ,呈发育不良改变。畸形位置愈高 ,神经元数量减少愈明显 ;②本研究结果提示人类先天性肛门直肠畸形术后便秘的发生可能与副交感神经元数量减少有关。Objective To assess the rectal parasympathetic innervation in rats with anorectal malformation.Methods 20 pregnant Wistar rats were divided into ETU-administration and control groups. On the 20th day of gestation,5% Fluorogold (FG) was injected into live fetal rectum or the rectal pouch. The FG-labeled parasympathetic neurons were counted. The morphology and distribution of the neurons were recorded.Results The SPN neurons innervating rectum were located mainly in the lateral zone of the 6th segment of lumber and the 1st sacral cord. The total number of FG-labeled SPN neurons in the fetuses exposed to ETU without developing anorectal malformation,and those with low type of deformity,high type of deformity and normal controls were (mean±S.D.) 899±36,588±102,242±92 and 901±46 respectively. The size of the FG-labeled SPN neurons in the fetuses with anorectal malformation was smaller.Conclusions 1.FG-labelled SPN neurons in the fetuses with anorectal malformation is significantly fewer than those in the fetuses without anorectal malformation( P < 0.05 ) and that in normal controls. The higher the deformity,the less the SPN neurons. 2. From the results of the experiment,we hypothesized that decrease of the SPN neurons quantity and the developmental defect of SPN might be one of the causes of the postoperative constipation in ARM.

关 键 词：先天性肛门直肠畸形 胎鼠 腰骶髓 副交感神经元 神经发育异常 排便功能 

分 类 号：R726.5[医药卫生—儿科]