摘要
实验将１２只犬分为Ｌ＿４吻接Ｓ＿２组、骶神经游离桥接组及对照组三组。所有犬在术前、术后及处死前行尿流动力学检查。膀胱容积压力测定的结果表明两神经修复组平均在手术后７个月出现通尿肌反射，证明膀胱的功能已有恢复。ＳＭＥＰ检查结果表明两修复组神经有所恢复。免疫组织化学的方法对神经轴突行特异性染色，图像分析方法对神经吻合口近、远端横截面进行神经纤维计数对比，两修复组与对照组有显著性差异。对两只行Ｌ＿４桥接Ｓ＿２神经的狗以辣根过氧物酶（ＨＲＰ）行神经示踪检查，证实运动性轴突已长入膀胱，实现了Ｌ＿４躯体运动神经对膀胱的神经再支配。尿道括约肌功能观察结果显示，虽然术后肌电图有一定恢复，但术后尿道压力无任何变化，尿道括约肌功能恢复仍不理想。实验结果表明，用腰神经吻接骶神经或用游离骶神经桥接的方法修复主要支配膀胱功能的骶神经以恢复排尿功能是可行的。
Abstract12 dogs were divided into three groups of L_4 root crossover anastomosis S_2 root, sacral root free anasto-mosis and control. All dogs received urodynamic test before and after operation and before sacrmce. The re-sults of cystometry demonstrated the detrusor reflex had returned 7 months after operation in two groups of nerve renovation. The characteristics of axonal regen-eration were revealed by immunohisto-cytochemistry and the count of nerve fibres number;was compared with that by morphometric analysis in proximal and distal end of anastometric stoma;The comparison dis-played a significant difference between nerve anastomo-sis groups and control group.Neural tracing study with horseradish peroxidase(HRP) in two dogs with the op-eration of L_4 crossover S_2 showed that lumbar somatic motor axons had regenerated successfully into the bladder and replaced previous sacral parasym-pathetic.Urethral sphincter function was still poor and urethralpressure was not changed post-operathdy,though theelectromyograme showed some improvement.Themethod of lummbar root or free sacral root anastomosiswith sacral root is practicable for restoration of bladderfunction.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1995年第12期719-722,共4页
Chinese Journal of Surgery
