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：我们研究了磁刺激脊神经诱发家兔和儿童肛门外括约肌（EAS）抽搐收缩的适当方法，并探讨了其在小儿外科领域的临床意义。方法：使用EMG分析仪（MEM 4204，Nihon Kohden）记录肛门边缘EAS的肌电图（EMG）。磁激励器（SMN-100，Nihon Kohden）和8字形线圈（YM-111B，Nihon Kohden）。在15只白色家兔的动物实验中，磁刺激脊神经可有效地引起EAS的收缩。磁刺激胸腰椎可记录到可重复的单相EMG，而刺激骶椎可记录到多相EMG，表明马尾神经水平的阴部神经多样性。在15名健康儿童中，仅在腰和囊水平刺激时诱发EAS的抽搐收缩 ...更多信息 脊神经节段和腰脊神经节段刺激可用于肌电图潜伏期的测定。在4例术前和12例术后肛门直肠畸形患者中，磁刺激可诱导EAS的抽搐收缩。结合磁刺激脊髓和经肛电刺激阴部神经诱发EAS收缩的研究结果，可正确估计每例患者阴部神经紊乱的部位和程度。先天性巨结肠和肛门直肠畸形患者术后肠功能障碍与阴部神经功能障碍密切相关。此外，在长期黄疸术后胆道闭锁患者，存在体感诱发电位异常，而不是由于维生素E缺乏，这可以改善肝transplantation.Conclusion：磁脊髓刺激是一种非侵入性的方法，以唤起EAS收缩儿童和这项技术是有用的EAS功能的正常和儿科患者的评价。少

项目成果

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,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。”

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。”

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。”