幼兔逼尿肌无收缩模型的建立及影像尿动力学评估  

A spinal cord transection-induced neurogenic bladder model and its video-urodynamic evaluation in young rabbit

作　　者：文建国[1,2] 苏志强[1,2] 王庆伟[1,2] 夏明亮[1,2] 任川川[1,2] 郭战[1,2] 杨超[1,2] 吕宇涛[1,2] 张燕莎[1,2] 张艳[1,2] 

机构地区：[1]郑州大学第一附属医院小儿尿动力学中心和泌尿外科450052 [2]河南省高等学校临床医学重点学科开放实验室

出　　处：《中华小儿外科杂志》2013年第5期373-376,共4页Chinese Journal of Pediatric Surgery

基　　金：基金项目：国家自然科学基金（编号：30901485）

摘　　要：目的建立幼兔脊髓横断（spinal cord transection，SCT）模型并对其进行尿动力学评估，为逼尿肌无收缩（Acontractile detrusor，ACD）的临床研究提供参考。方法18只日本大耳白兔[体质量1．2～1．6kg，平均（1．36±0．11）kg，7～9周龄]随机分为SCT组（n=12）和假手术（sham）组（n=6）。SCT组采用改进的方法在第六腰椎水平横断脊髓并破坏骶髓，sham组于第六腰椎水平仅咬除棘突暴露脊髓。观察两组术后神经损害表现并进行影像尿动力学评估。结果SCT组术后出现后肢瘫痪等脊髓损伤表现，sham组（n=6）未见明显神经损伤表现。影像尿动力显示SCT组家兔膀胱容量显著增加，最大测压膀胱容量SCT组和sham组分别为（95．7±7．19）ml、（51．6±4．07）ml（P〈0．001）；膀胱顺应性、逼尿肌漏尿点压、排尿期最大逼尿肌压力两组差异均有统计学意义（P〈0．001）。结论此种脊髓横断方法能建立幼兔ACD模型，为临床研究提供参考。Objective To establish a spinal cord transection（SCT） induced neurogenic bladder （NB） model in young rabbit and to evaluate using video-urodynamic study. Methods Eighteen young male Japanese White rabbits [weighing 1.2 - 1.6 kg, （ 1.36 ± 0. 11 kg）, 7 - 9 weeks old] were ran- domly divided into SCT （n = 12） and sham group （n= 6）. SCT group had a modified method of spinal cord transection at the sixth lumbar level. Sham group had only part excision of the spinous process at the same level, exposing spinal cord. Video-urodynamic assessment was performed in the second month postoperation. Results SCT group showed a typical postoperative manifestation of hindlimb pa- ralysis. The sham group （n = 6） showed no significant abnormality. Bladder capacity increased signifi- cantly in SCT group, the maximum cystometric capacities in SCT group and sham group were 95.7± 7.19 ml vs. 51.6 ±4.07 ml （P〈0.001） ; bladder compliance was 11.32 ± 1.98 ml/cm H20 vs. 5. 19 ±0. 26 ml/cm H20, respectively （P^0. 001）; detrusor leak point pressures （DLPP） were 9. 36 ± 2. 33 cm H20 vs. 18. 67 ± 2. 66 cm H20 （P%0.001） ; the maximum detrusor pressure during voiding were 8.50 ± 3.34 em H20 vs. 31.33 ± 7.20 cm H2O （P〈0.001 ）. Conclusions This improved method of spinal cord transection can be used to establish an immature rabbit model with acontractile detrusor for clinical research on neurogenic bladder.

关 键 词：膀胱 神经源性 脊髓 影像尿动力学 

分 类 号：R726[医药卫生—儿科] R6[医药卫生—临床医学] R-332