Intermittent catheterization limits rabbit bladder dysfunction in response to partial outlet obstruction
Intermittent catheterization limits rabbit bladder dysfunction in response to partial outlet obstruction
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DOI：
10.1016/s0022-5347(05)68040-8
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发表时间：
2000-01-01
影响因子：
6.6
通讯作者：
Levin, RM
中科院分区：
文献类型：
--
作者：
Ohnishi, N;Horan, P;Levin, RM
简介：膀胱对流出道部分阻塞的最初反应包括扩张，随后质量迅速增加和随之而来的功能适应。随后，出现一个不确定的稳定功能期和质量的少量增加（补偿）。最后，膀胱质量再次进行性增加，伴随着膀胱形态、生物化学和药理学的有害变化，以及功能的进行性丧失（失代偿）。报告的研究旨在确定是否限制膀胱扩张的水平，使用间歇性导管插入术（IntCath），可以保护膀胱失代偿.Materials和方法：16只雄性新西兰白色兔分为4组，每组4只：对照组，对照组与IntCath，阻塞，阻塞与IntCath。在吸入麻醉下对动物进行IntCath。每8小时将8 Fr导管通过尿道插入膀胱，并排出尿液。梗阻14天后，从所有家兔中取出膀胱;从膀胱体上切下纵向条带并悬挂在单个器官浴中。收缩反应场刺激（FS），氯化钾，ATP，和卡巴胆碱measured.Results：有没有显着差异对照兔和对照组与IntCath膀胱重量，顺应性和收缩反应的所有刺激。两个梗阻组的膀胱重量与两个对照组相比显著增加。梗阻家兔的膀胱重量增加的程度显著大于使用IntCath的梗阻家兔。梗阻组的膀胱顺应性显著低于两个对照组和IntCath梗阻家兔的顺应性。与对照组相比，两个阻塞组均表现出对FS、ATP和KCl的收缩反应显著降低。阻塞组与IntCath FS和卡巴胆碱的反应显着大于阻塞组的反应没有IntCath.Conclusions：这些研究结果表明，限制扩张与IntCath减少的幅度增加膀胱质量，膀胱壁弹性（顺应性）的损失，和受损的收缩反应发生继发于流出道梗阻。
Introduction: The initial response of the urinary bladder to outflow partial obstruction consists of distension, followed by a rapid increase in mass and concomitant; functional adaptations. Subsequently, an indeterminate period of stabilized function and little increase in mass occurs (compensation). Finally, bladder mass again progressively increases, accompanied by deleterious changes in bladder morphology, biochemistry and pharmacology, and progressive loss of function (decompensation). The reported study was designed to determine whether limiting the level of bladder distension, using intermittent catheterization (IntCath), could protect the bladder from decompensation.Materials and Methods: Sixteen male New Zealand White rabbits were separated into 4 groups of 4 rabbits each: control, control with IntCath, obstructed, and obstructed with IntCath. IntCath was performed with the animals under inhalation anesthesia. An 8 Fr. catheter was inserted through the urethra into the bladder every 8 hours and the urine drained. After 14 days of obstruction, bladders were removed from all rabbits; longitudinal strips were cut from the bladder body and suspended in individual organ baths. Contractile responses to field stimulation (FS), KCl, ATP, and carbachol were measured.Results: There were no significant differences between control rabbits and controls with IntCath in bladder weights, compliance, and contractile responses to all stimuli. Bladder weights of both obstructed groups increased significantly compared to those of both control groups. Bladder weights of obstructed rabbits increased to a significantly greater extent than did those of obstructed rabbits with IntCath. Bladder compliance in the obstructed group was significantly lower than compliance in both control groups and in obstructed rabbits with IntCath. Both obstructed groups exhibited significantly decreased contractile responses to FS, ATP and KCl, compared to control groups. The response of the obstructed group with IntCath to FS and carbachol was significantly greater than the responses of the obstructed group without IntCath.Conclusions: These findings show that limiting distension with IntCath reduces the magnitudes of the increased bladder mass, the loss of bladder wall elasticity (compliance), and the impaired contractile responses which occur secondary to outflow obstruction.