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猫急性选择性骶神经根切断术对膀胱和尿道功能及对氯化氨甲酰甲胆碱反应的影响

Effect of acute selective sacral rhizotomy in cats on bladder and urethral function and the response to bethanechol chloride.

作者信息

el-Salmy S, Downie J W, Awad S A

出版信息

J Urol. 1985 Oct;134(4):795-9. doi: 10.1016/s0022-5347(17)47441-6.

Abstract

Bladder and urethral responses to filling and to subcutaneous bethanechol are dependent upon intact sacral innervation. Acute selective sectioning of nerve roots in chloralose anesthetized cats was used to compare the sacral innervation requirements for the support of these responses. The detrusor was found to require primarily intact S2 roots although an S2 root on one side could, alone, subserve a weak, unsustained detrusor reflex. The urethral reaction to bladder filling required an afferent sacral pathway through either S1 or S2 roots. The sustained bladder response to subcutaneous bethanechol required greater sacral innervation than the detrusor reflex inasmuch as the S2 segment could subserve this response in only half the cases, and unilateral rhizotomy L7-S3 eliminated the response in half the cases. Both treatments, however, were compatible with a preserved detrusor reflex. The urethral constriction response to subcutaneous bethanechol required an intact sacral afferent pathway through either the S1 or S2 segments. In conclusion, the detrusor and urethral reflex responses to bladder filling and subcutaneous bethanechol require a certain amount of intact sacral innervation through S1 and S2 which is least for the detrusor reflex and greatest for the bladder response to subcutaneous bethanechol.

摘要

膀胱和尿道对充盈及皮下注射氨甲酰甲胆碱的反应依赖于完整的骶神经支配。通过对水合氯醛麻醉的猫进行神经根急性选择性切断,以比较支持这些反应所需的骶神经支配情况。结果发现,逼尿肌主要需要完整的S2神经根,尽管一侧的S2神经根单独即可产生微弱、持续时间短的逼尿肌反射。尿道对膀胱充盈的反应需要通过S1或S2神经根的骶传入通路。与逼尿肌反射相比,膀胱对皮下注射氨甲酰甲胆碱的持续反应需要更多的骶神经支配,因为S2节段仅在半数情况下能产生这种反应,而单侧L7 - S3神经根切断术在半数情况下可消除该反应。然而,这两种处理均与保留的逼尿肌反射相容。尿道对皮下注射氨甲酰甲胆碱的收缩反应需要通过S1或S2节段的完整骶传入通路。总之,膀胱充盈及皮下注射氨甲酰甲胆碱时,逼尿肌和尿道的反射反应需要通过S1和S2的一定量完整骶神经支配,其中对逼尿肌反射所需最少,对膀胱对皮下注射氨甲酰甲胆碱的反应所需最多。

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