在保留神经的根治性子宫切除术中测量膀胱逼尿肌肌电图活动。
The measurement of vesical detrusor electromyographic activity during nerve-sparing radical hysterectomy.
机构信息
Department of Obstetrics and Gynecology, Nan fang Hospital of Southern Medical University, Guangzhou, People's Republic of China.
出版信息
Reprod Sci. 2010 Dec;17(12):1144-52. doi: 10.1177/1933719110383969.
OBJECTIVE
To evaluate the feasibility for confirming the preservation of the parasymphathetic nerve pathway innervating the bladder during nerve-sparing radical hysterectomy (RH).
METHODS
A total of 20 patients underwent nerve-sparing RH. Intraoperative electrical stimulation (IES) were performed on the root of pelvic splanchnic nerve (PSN) trunk while recording the electromyographic (EMG) activity of the vesical detrusor. The average duration achieving residual urine ≤50 mL and urodynamic study (UDS) was observed.
RESULTS
Evoked potentials were recorded when stimulating, in 18 patients who were referred IES-positive. Its duration was 9.89 days. The UDS results indicated that all voided normally. The remaining 2 IES-negative cases with no evoked potentials had longer duration and the micturitions were performed using abdominal pressure.
CONCLUSION
During nerve-sparing RH, IES based on the measurement of EMG activity is a useful tool for confirmation of the preservation of parasymphathetic nerve pathway innervating the bladder and prediction of the postoperative bladder function.
目的
评估在保留交感神经的根治性子宫切除术（RH）中确认支配膀胱的副交感神经通路保留的可行性。
方法
共 20 例患者接受保留交感神经的 RH。在记录膀胱逼尿肌的肌电图（EMG）活动的同时，对盆丛神经主干的根部进行术中电刺激（IES）。观察达到残余尿量≤50ml 和尿动力学研究（UDS）的平均持续时间。
结果
18 例患者被认为 IES 阳性，记录到了诱发电位。其持续时间为 9.89 天。UDS 结果表明所有患者均正常排尿。另外 2 例 IES 阴性患者没有诱发电位，其持续时间更长，排尿需要使用腹压。
结论
在保留交感神经的 RH 中，基于 EMG 活动测量的 IES 是确认支配膀胱的副交感神经通路保留和预测术后膀胱功能的有用工具。
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