Micturition reflex arc reconstruction including sensory and motor nerves after spinal cord injury: Urodynamic and electrophysiological responses
Micturition reflex arc reconstruction including sensory and motor nerves after spinal cord injury: Urodynamic and electrophysiological responses
复制标题
脊髓损伤后排尿反射弧重建，包括感觉和运动神经：尿动力学和电生理反应
DOI：
10.1179/2045772311y.0000000030
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发表时间：
2011-09
影响因子：
1.7
通讯作者：
Cao, Xiao Jian
中科院分区：
文献类型：
--
作者：
Ma, Jun;Sui, Tao;Zhu, YuCheng;Zhu, AiXiang;Wei, ZhongQing;Cao, Xiao Jian
摘要目的应用尿动力学和电生理记录评价人工反射弧的排尿功能。实验设计将16只比格犬随机分为两组。方法A组行左侧L7腹根近端与左侧S2腹根远端吻合，L7背根与S2背根吻合，重建膀胱感觉和运动功能。B组将左侧L7 VR近端和左侧S2 VR远端缝合，保留左侧L7 DR，重建膀胱运动功能。结果测量包括电生理测试和尿动力学测量。此外，我们还监测了尿路感染率。结果电刺激左侧S2 DR，A、B组在脊髓下运动神经元损伤前后均使膀胱压力升高。单次刺激两组均诱发动作电位。在脊髓下运动神经元损伤后3个月内，A组（3次）和B组（8次）发生了尿路感染。结论两种重建方法均能诱导膀胱排尿和诱发动作电位。而A组脊髓下运动神经元损伤后排尿反应较好，尿路感染发生率较低。因此，在A组中使用的人工生理反射弧重建方法，与病变上方的感觉输入，可能会提供一个更好的选择，在临床实践中。
Abstract Objective To evaluate artificial reflex arcs for micturition using urodynamics and electrophysiological recordings. Design Sixteen beagles were equally and randomly divided into two groups. Methods In group A, anastomosis of the proximal end of the left L7 ventral root (VR) and distal end of the left S2 VR was performed, as well as anastomosis of the L7 dorsal root (DR) and S2 DR to reconstruct the sensory and the motor function of the bladder. In group B the proximal end of the left L7 VR and the distal end of the left S2 VR were anastomosed, while the left L7 DR was kept intact to reconstruct the motor function of the bladder. Outcome measures included electrophysiological testing and the urodynamic measures. In addition, we also monitored urinary infection rates. Results Stimulation to the left S2 DR in groups A and B both elevated the bladder pressure before and after the spinal lower motor neuron lesion. Single stimulation of the two groups both elicited evoked action potentials. Urinary infections occurred in group A (three occurrences) and in group B (eight occurrences) during the 3 months after the spinal lower motor neuron lesion. Conclusion Data showed that both reconstructive methods could induce bladder micturition and evoked action potentials. However, in group A the micturition response was better and the urinary infection rates were lower after the spinal lower motor neuron lesion. Thus, the artificial physiological reflex arc reconstruction method used in group A, with sensory input above the lesion, might provide a better alternative in clinical practice.
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DOI：
10.1055/s-0028-1090599
发表时间：
2008-09
期刊：
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影响因子：
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影响因子：
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DOI：
10.1016/s0022-5347(17)45141-x
发表时间：
1986-10
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影响因子：
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B. Vorstman;S. Schlossberg;L. Kass;C. Devine