聚丙烯阴道无张力悬吊带对压力性尿失禁大鼠模型膀胱和尿道结构及功能的长期影响  

Long-term effect of polypropylene transobturator tension-free vaginal tape on the structures and functions of urethra and bladder in a rat model of stress urinary incontinence

作　　者：张春青[1] 杜志刚[2] 张彦[1] 

机构地区：[1]唐山市第三医院妇产科,河北省唐山市063000 [2]华北煤炭医学院附属医院神经内科,河北省唐山市063000

出　　处：《中国组织工程研究与临床康复》2008年第6期1077-1080,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察应用人工材料由内向外经闭孔阴道无张力吊带(transobturator tension-free vaginal tape,TVT-O)治疗雌性大鼠压力性尿失禁模型的长期疗效,以及聚丙烯吊带对膀胱尿道结构功能的影响。方法:实验于2006-06/2007-06在华北煤炭医学院动物中心实验室完成。选取青春期雌性SD大鼠24只,随机分为4组:①对照组只游离阴部神经,但不切断。②压力性尿失禁组、假手术组和TVT-O组行双侧阴部神经切断术建立压力性尿失禁模型。然后假手术组按TVT-O术操作,但不置入吊带;TVT-O组行标准的TVT-O术。于术后6周行腹压漏尿点压测定和膀胱测压。结果:23只大鼠进入结果分析。①腹压漏尿点压:压力性尿失禁组低于对照组(P=0.028),TVT-O组恢复到对照组水平(P=0.686)。②最大逼尿肌收缩压:各组比较差异无显著性意义(P>0.05)。③膀胱容量:TVT-O组高于对照组和压力性尿失禁组(P<0.05)。④膀胱顺应性:TVT-O组高于压力性尿失禁组(P<0.05)。结论:①应用人工合成材料聚丙烯吊带行TVT-O治疗大鼠压力性尿失禁安全、长期有效,不影响膀胱的收缩功能,但可以使膀胱容量和顺应性增加。②双侧阴部神经切断术可以建立长期稳定的压力性尿失禁大鼠模型。AIM： To observe the long-term efficacy of transobturator tension-free vaginal tape （TVT-O） in a female rat model of stress urinary incontinence （SUI）, and study the effect of polypropylene sling on the structures and functions of urethra and bladder. METHODS： The experiment was carried out in the Animal Central Laboratory of North China Coal Medical College between June 2006 and June 2007. A total of 24 female SD rats at adolescence were randomly assigned to 4 groups.1.Control group： pudendal nerve was mobilized, but pudendal nerve transection was not performed.2.SUI group, sham group and TVT-O group： SUI was created in the 3 groups by bilateral pudendal nerve transection. Then TVT-O was performed in the sham group and TVT-O group, but a strip of polypropylene mesh was not placed in the sham group. After 6 weeks, abdominal leak point pressure （ALPP） and cystometry were measured in each rat. RESULTS： Twenty-three rats were involved in the result analysis.1.There was a significant decrease of ALPP in SUI group compared to control group （P=0.028）. TVT-O could recover ALPP to normal value （P=0.686）.2.The maximal detrusor pressure had no difference significantly among each group （P 〉 0.05）.3.The volume of bladder in TVT-O group significantly increased compared to that in control group and SUI group （P 〈 0.05）.4.The compliance of bladder in TVT-O group was significantly higher than that in SUI group （P 〈 0.05）. CONCLUSION： 1.The treatment of TVT-O with polypropylene sling for rat SUI model is safe and has a long-term efficacy. Polypropylene sling does not affect the bladder contraction, but results in an increase of bladder volume and compliance.2.Durable and stable rat SUI model can be created by bilateral pudendal nerve transection.

关 键 词：聚丙烯吊带 压力性尿失禁 经闭孔阴道无张力吊带术 腹压漏尿点压 膀胱顺应性 生物材料 

分 类 号：R318[医药卫生—生物医学工程]