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[关于诱导排尿的人工体-自主神经通路的电生理研究]

[An electrophysiological study on the artificial somato-autonomic pathway for inducing voiding].

作者信息

Liu Zhao, Liu Chang-jin, Hu Xin-wu, Du Mao-xin, Xiao Chuan-guo

机构信息

Department of Urology, Xiehe Hospital, Tongji Medical College, Huanzhong University of Science and Technology, Wuhan 430022, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2005 May 25;85(19):1315-8.

Abstract

OBJECTIVE

To investigate the possibility of regeneration of somatic motor nerve to replace splanchnic nerve and the electrophysiologic characters of the regenerated nerve.

METHODS

An artificial somato-autonomic reflex pathway was established by intradural microanastomosis of L(4) ventral root (VR) to L(6)VR at the left side in 12 male Wistar rats. Then the L(4)VR proximal to the anastomosis was stimulated by silver electrode and the evoked potentials were recorded on the distal end to the anastomosis, pelvic nerve and postganlionic fibers of the major pelvic ganglia (MPG). Cystometrography was used to record the intravesical pressure. Hexamethonium, a cholinergic ganglion blocker, was given directly on the pelvic ganglion so as to observe the change of the intravesical pressure evoked by stimulation of the nerves. Another 12 rats were used as controls.

RESULTS

(1) In the experimental group, stimulation of the L(4)VR proximal end to the anastomosis evoked potentials on the distal end, the pelvic nerve, and the postganglionic fibers of the MPG, and induced bladder contraction. Stimulation of the contralateral sciatic nerve failed to evoke change of intravesical pressure. In the control group stimulation of the L(4)VR or sciatic nerve failed to evoke potentials on the postganglionic fibers of pelvic nerve and change of intravesical pressure. (2) Stimulation of the ipsilateral sciatic nerve led to an increase of intravesical pressure. (3) After the use of hexamethonium stimulation of the ipsilateral sciatic nerve and proximal end of L(4)-L(6) anastomosis failed to evoke change of intravesical pressure. (4) The conduction velocity of the regenerated motor axons was 33.3 m/s +/- 6.9m/s, significantly higher than that of the control group (11.6 m/s +/- 1.6 m/s).

CONCLUSION

Somatic motor axons can regenerate to the MPG and reinnervate the bladder and the impulses from the somatic motor neurons can initiate voiding.

摘要

目的

探讨躯体运动神经再生替代内脏神经的可能性及再生神经的电生理特性。

方法

对12只雄性Wistar大鼠在硬膜内将左侧L(4)腹根(VR)与L(6)VR进行显微吻合,建立人工体-自主神经反射通路。然后用银电极刺激吻合口近端的L(4)VR,并在吻合口远端、盆神经及盆大神经节(MPG)的节后纤维上记录诱发电位。用膀胱测压法记录膀胱内压。将胆碱能神经节阻滞剂六甲铵直接作用于盆神经节,观察神经刺激诱发的膀胱内压变化。另取12只大鼠作为对照。

结果

(1)实验组刺激吻合口近端的L(4)VR,在吻合口远端、盆神经及MPG的节后纤维上引出诱发电位,并引起膀胱收缩。刺激对侧坐骨神经未能引起膀胱内压变化。对照组刺激L(4)VR或坐骨神经未能在盆神经节后纤维上引出电位及膀胱内压变化。(2)刺激同侧坐骨神经可使膀胱内压升高。(3)应用六甲铵后,刺激同侧坐骨神经及L(4)-L(6)吻合口近端均未能引起膀胱内压变化。(4)再生运动轴突的传导速度为33.3 m/s±6.9m/s,明显高于对照组(11.6 m/s±1.6 m/s)。

结论

躯体运动轴突可向MPG再生并重新支配膀胱,躯体运动神经元发出的冲动可启动排尿。

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