Establishment of the proper method of magnetic stimulation of spinal and pelvic nerve in children and investigation of its clinical significance.

儿童脊骨神经磁刺激正确方法的建立及临床意义探讨

• 批准号: 08672058
• 负责人: KUBOTA Masayuki
• 金额: $ 1.34万
• 依托单位: Kyushu University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08672058/
• 关键词: magnetic stimulation; external anal sphincter; sacral nerve; pelvic nerve; anorectal malformation; Hirschsprung's disease; billiary atresia; rabbit; 家兎

Purpose : We have investigated the proper method of magnetic stimulation of the spinal nerve to evoke a twitch contraction of the external anal sphincter (EAS) in rabbit and children, and its clinical significance in the field of pediatric surgery was investigated.Method : The electromyogram (EMG) of the EAS was recorded at the anal verge using EMG analyzer (MEM 4204, Nihon Kohden). Magnetic stimulator (SMN-100, Nihon Kohden) and figure eight coil (YM-111B,Nihon Kohden) were used.Result : In animal studies using l5 white rabbits, magnetic stimulation of the spinal nerve was quite effective to induce a contraction of EAS.A reproducible monophasic EMG was recorded in response to a magnetic stimulation of thoracic and lumbar spine, while multiphasic EMG was induced to stimulation of the sacral segment, suggesting a diversity of the pudendal nerve at the level of the cauda equina. In l5 healthy children, a twitch contraction of EAS was evoked only to stimulation at levels of lumbar and sac … More ral segment and lumbar spinal stimulation was suitable for a measurement of EMG latency. Magnetic stimulation was useful to induce a twitch contraction of the EAS in 4 pre-operative and l2 post-operative patients with anorectal malformation. Site and degree of pudendal nerve disturbance in each patient could be estimated properly in combination with the present result using magnetic spinal stimulation and previous results using the transanal electrical stimulation of the pudendal nerve to induce EAS contraction.As the results of on-going research projects from l994, a close correlation of post-operative bowel dysfunction and pudendal nerve dysfunction could be demonstrated in patients with Hirschsprung's disease and anorectal malformation. Furthermore, in long-standing icteric post-operative patients with biliary atresia, the presence of somatosensory evoked potential abnormality not due to vitamin E deficiency was also revealed, which could be improved by the liver transplantation.Conclusion : Magnetic spinal stimulation was a non-invasive method to evoke EAS contraction in children and this technique was useful in an evaluation of EAS function in the normal and the pediatric patients. Less

目的：我们研究了对脊神经进行磁刺激以引起兔子和儿童肛门外括约肌（EAS）抽搐的正确方法，并研究了其在小儿外科领域的临床意义。方法：使用肌电图分析仪（MEM 4204，Nihon Kohden）在肛门边缘记录 EAS 的肌电图（EMG）。使用磁刺激器（SMN-100，Nihon Kohden）和 8 字形线圈（YM-111B，Nihon Kohden）。结果：在使用 l5 只白兔的动物研究中，脊神经的磁刺激对于诱导 EAS 收缩非常有效。响应于胸椎和腰椎的磁刺激，记录了可重复的单相肌电图，同时诱导了多相肌电图 骶段的刺激，表明马尾神经水平的阴部神经的多样性。在 15 名健康儿童中，仅在腰椎和囊水平刺激时才会诱发 EAS 抽搐收缩，而腰节和腰椎刺激适合测量肌电图潜伏期。磁刺激可有效诱导 4 名肛门直肠畸形术前患者和 12 名术后患者 EAS 抽搐。结合目前使用磁脊髓刺激的结果和以前使用经肛门电刺激阴部神经诱导 EAS 收缩的结果，可以正确估计每个患者阴部神经紊乱的部位和程度。正如 1994 年正在进行的研究项目的结果一样，可以证明术后肠道功能障碍与阴部神经功能障碍密切相关。 先天性巨结肠症和肛门直肠畸形。此外，在术后长期黄疸的胆道闭锁患者中，也发现存在非维生素E缺乏所致的体感诱发电位异常，这可以通过肝移植得到改善。结论：脊髓磁刺激是一种诱发儿童EAS收缩的无创方法，该技术可用于评估正常人和儿童的EAS功能。 患者。较少的

项目成果

Kubota M,et al: "Investigation of bowel function and QOL in post-operative patients of adult age with anorectal malformation." J Jpn Surg Soc. 98. 45 (1997)

Kubota M 等人：“成人肛门直肠畸形术后患者肠道功能和生活质量的调查。”

Kubota M: "Evoked potential abnormalities in post-operative patients with biliary atresia." Pediatric Neurology. 16(3). 206-212 (1997)

Kubota M：“引起胆道闭锁术后患者潜在的异常。”

Kamimura T.et al: "No mediated innervation in the aganglionic segment in patients with Hirschsprung's disease." J Jpn Soc Pediatr Surg. 32(3). 501 (1996)

Kamimura T.等人：“先天性巨结肠患者的无神经节段没有介导的神经支配。”

M.Kubota,T.Kamimura,S.Suita: "Abnormalities in visceral-evoked potentials from the anal canal in children with chronic constipation." Surgery Today (accepted). (1997)

M.Kubota、T.Kamimura、S.Suita：“慢性便秘儿童肛管内脏诱发电位异常。”

M.Kubota,S.Suita,T.Kamimura,K.Shono: "Evoked potential abnormalities in post-operative patients with biliary atresia." Pediatric Neurology. (accepted). (1997)

M.Kubota、S.Suita、T.Kamimura、K.Shono：“在胆道闭锁术后患者中诱发潜在异常。”