骶神经根电刺激对鼠神经原性膀胱储尿功能的影响

背景神经原性膀胱最为典型也最有临床意义的表现为患者的储尿功能障碍,其发生大多直接或间接与骶神经根功能的失调有关,因而骶神经根埋植式电刺激被认为是一种可能的较好的治疗手段,可通过对骶髓排尿及控尿中枢的调节而改善储/排尿.目的探讨骶神经根埋植式电刺激对大鼠神经原性膀胱储尿功能的影响.设计完全随机的对照实验研究.地点和材料Wistar雌性大鼠 20只,体重 180～ 220 g,由第三军医大学动物实验中心提供.制作神经原性大鼠膀胱模型,并将其随机分为刺激组及对照组.干预刺激组予埋植式骶神经根电刺激治疗,对照组予假手术.主要观察指标电刺激 1月后观察尿动力学改变及 Caspase3mRNA表达的变化.结果 电刺激1月后膀胱储尿能力明显加强,膀胱容量增加 (0.095± 0.083) mL,顺应性显著升高(t=-3.92,P< 0.05), Caspase3mRNA表达较对照组显著降低 (0.58± 0.44).结论 骶神经根电刺激可显著改善神经原性膀胱的储尿能力,并能延缓逼尿肌细胞的凋亡,保存逼尿肌功能.

Effect of sacral nerve root stimulation on the storage of neurogenic bladder of rats

BACKGROUND:The typical manifestation of neurogenic bladder is the dysfunction of bladder storage. This situation relates to the disorder of the sacral nerve directly or indirectly.To implant electrical sacral nerve root stimulator is believed to be a good method to improve the storage and voiding, by modulating the sacral spine. OBJECTIVE:To detect the effect of sacral nerve root stimulation on the neurogenic bladder. DESIGN:A total randomized and controlled study. SETTING and MATERIALS:Twenty female wistar rats,weighing 180-220 g,were provided by Center for Experimental Animals,Third Military Medical University.Models of neurogenic bladder were made, and divided randomly into the stimulation group(n=10) and the control group(n=10). INTERVENTION:Sacral nerve root stimulation is performed on the stimulation group, but not on the control group. MAIN OUTCOME MEASURE:After a month's stimulating, the urodynamics and the Caspase3 mRNA were detected. RESULTS:The storage volume of bladder increased significantly, with the bladder capacity increased by (0.095± 0.083) mL, and the bladder compliance increased(t=-3.92,P< 0.05).The expression of caspase3 mRNA decreased significantly by 0.58± 0.44 against the control group. CONCLUSION:Sacral nerve root simulation can significantly improve the storage of neurogenic bladder,and can postpone the apoptosis of the detrusor cells.