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[腰椎间盘突出症致神经源性膀胱功能障碍新模型的建立及其尿动力学评价]

[Establishment of a new model of neurogenic bladder dysfunction caused by lumbar intervertebral diskhernia and its urodynamic evaluation].

作者信息

Dong De-xin, Xu Zhi-shun, Shi Ben-kang, Zhou Zun-lin, Jiang Xian-zhou, Chen Jun, Wang Hai-xin

机构信息

Department of Urology, Qilu Hospital of Shandong University, Jinan 250012, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 Jun 26;87(24):1723-5.

Abstract

OBJECTIVE

To establish a new rat model of neurogenic bladder dysfunction caused by lumbar intervertebral disk hernia, and to confirm the model by urodynamic examination.

METHODS

Twenty male Wistar rats were divided into two groups at random:experimental group (n = 15) and pseudo-operation group (n = 5). The rats underwent laparotomy to disclose the intervertebral disk of L(6)-S(1), and a 1.50 mm x 4.50 mm blunt screw with flat end was inserted into the intervertebral disk of L(6)-S(1) of the rats in the experimental group so as to establish the model of lumbar intervertebral disk hernia. Computed radiography (CR) was performed 3 days after the operation to conform the successful insertion of the screw. Combined behavioral score (CBS) was used 1 d, 3 d, 1 week, 2 weeks, and 4 weeks after the operation. Four weeks after the laparotomy a vesical fistula above the pubis was made in all of the rats, and then urodynamic examination was performed three days after this operation.

RESULTS

CR after operation confirmed that the blunt screw had been inserted into the lumbar disk of L(6). The CBS scores of the 2 groups at different time points all decreased along with time, and basically remained unchanged 1 week after. The CBS scores of the experiment group were significantly higher than those of the pseudo-operation group (all P < 0.05). The spontaneous vesical contraction rate in the filling period of the experimental group was (4.37 +/- 2.13) times/min, significantly higher than that of the pseudo-operation group [(0.06 +/- 0.13) times/min, t = 4.425, P = 0.000], the maximum bladder capacity of the experimental group was (1.20 +/- 0.34) ml, significantly greater than that of the pseudo-operation group [(0.60 +/- 0.14) ml, t = 5.141, P = 0.002], and bladder compliance of the experimental group was (0.024 +/- 0.012) ml/cm H(2)O, significantly lower than that of the pseudo-operation group [(0.096 +/- 0.088) ml/cm H(2)O, t = 2.891, P = 0.011], and the leak point pressure of the experimental group was (75 +/- 27) cm H(2)O, not significantly different from that of the pseudo-operation group [(62 +/- 23) cm H(2)O]. The urodynamic examination on the conscious rats confirmed the successful establishment of the neurogenic bladder dysfunction caused by lumbar intervertebral disk hernia.

CONCLUSION

A new model of neurogenic bladder dysfunction caused by lumbar intervertebral disk hernia has been established by insertion of a blunt screw into the lumbar intervertebral disk of L(6). The model is confirmed by urodynamic examination.

摘要

目的

建立一种由腰椎间盘突出症导致神经源性膀胱功能障碍的新型大鼠模型,并通过尿动力学检查对该模型进行验证。

方法

将20只雄性Wistar大鼠随机分为两组:实验组(n = 15)和假手术组(n = 5)。大鼠接受剖腹手术以暴露L6 - S1椎间盘,将一根1.50 mm×4.50 mm平头钝性螺钉插入实验组大鼠的L6 - S1椎间盘以建立腰椎间盘突出症模型。术后3天进行计算机X线摄影(CR)以确认螺钉成功植入。术后1天、3天、1周、2周和4周采用综合行为评分(CBS)。剖腹手术后4周,对所有大鼠进行耻骨上膀胱造瘘,然后在此手术后3天进行尿动力学检查。

结果

术后CR证实钝性螺钉已插入L6腰椎间盘。两组在不同时间点的CBS评分均随时间下降,1周后基本保持不变。实验组的CBS评分显著高于假手术组(均P < 0.05)。实验组充盈期膀胱自发收缩率为(4.37±2.13)次/分钟,显著高于假手术组[(0.06±0.13)次/分钟,t = 4.425,P = 0.000];实验组最大膀胱容量为(1.20±0.34)ml,显著大于假手术组[(0.60±0.14)ml,t = 5.141,P = 0.002];实验组膀胱顺应性为(0.024±0.012)ml/cm H₂O,显著低于假手术组[(0.096±0.088)ml/cm H₂O,t = 2.891,P = 0.011];实验组漏点压力为(7±27)cm H₂O,与假手术组[(62±23)cm H₂O]无显著差异。对清醒大鼠进行的尿动力学检查证实成功建立了由腰椎间盘突出症导致的神经源性膀胱功能障碍模型。

结论

通过将钝性螺钉插入L6腰椎间盘建立了一种由腰椎间盘突出症导致神经源性膀胱功能障碍的新型模型。该模型通过尿动力学检查得到验证。

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