建立人工膀胱反射弧恢复脊髓损伤患者排尿功能的初步报告

目的：探索建立人工膀胱反射弧恢复脊髓损伤患者排尿功能的治疗途径。方法：对３例圆锥上脊髓损伤（ＳＣＩ）患者行两侧Ｌ５－Ｓ２或Ｓ１－Ｓ３前根吻合，经１０－１２个月轴索再生后，检测膀胱排尿功能。结果：建立人工膀胱反射弧手术后，通过刺激躯体传入神经，可经内脏传出神经引发膀胱内压升高，在膀胱充盈较满时能引起排尿反应。结论：建立人工膀胱反射弧对ＳＣＩ患者排尿有一定作用，但尚需进一步研究完善。

Establishing an artificial somato-CNS-bladder reflex arc to restore controlled mic-turition in spinal cord injuries: a preliminary report

Objective: To introduce preliminary clinical results of artificial somato CNS bladder reflex arc established for controlled micturition in the spinal cord injury (SCI). Methods: Three supraconal SCI patients were included after urodynamic selection. Bilateral anterior root anastomoses of L 5 to S 2(1 case) or S 1 to S 3(2 cases) were carried out. After 10 to 12 months axonal regeneration, the effects were examined clinically and urodynamically. Results: Stimulation of the somatic afferent nerve by passive ankle movement or Achilles tendon stretch could induce an increase of intravescical pressure, and could cause reflex voiding provided the bladder was nearly full filled. Conclusion: Establishing somato CNS bladder artificial reflex arc may be effective for controlled micturition in SCI, but further studies are needed.