Azadzoi K M, Pontari M, Vlachiotis J, Siroky M B
Department of Urology, Boston University School of Medicine, Boston, Massachusetts 02130, USA.
J Urol. 1996 Apr;155(4):1459-65. doi: 10.1016/s0022-5347(01)66307-9.
To study changes in bladder blood flow and oxygenation associated filling, contraction and outlet obstruction.
Intravesical pressure, bladder flow, bladder wall oxygen tension, iliac artery blood flow and systemic blood pressure were measured simultaneously in anesthetized dogs (N = 18).
In the empty bladder, blood flow and oxygen tension in the bladder were greater than at the dome with and without outlet obstruction. Bladder filling caused a significant decrease in bladder wall blood flow and oxygen tension with or without outlet obstruction. Spontaneous bladder contractions resulted in a marked decrease in bladder wall perfusion in the obstructed bladder but not in the unobstructed bladder. Pelvic nerve stimulation produced strong bladder contractions associated with significant drop in bladder wall perfusion and bladder oxygenation in both the open and closed bladder neck models. Little change was noted after stimulation of the hypogastric nerve.
Bladder distention and contraction, especially against a closed bladder neck, induce significant ischemia and hypoxia of the bladder wall. These findings may be important in the pathophysiology of a variety of common clinical problems.
研究膀胱充盈、收缩及出口梗阻时膀胱血流和氧合的变化。
在麻醉犬(n = 18)身上同时测量膀胱内压、膀胱血流、膀胱壁氧分压、髂动脉血流及全身血压。
在膀胱空虚时,无论有无出口梗阻,膀胱内的血流和氧分压均高于膀胱顶部。膀胱充盈导致膀胱壁血流和氧分压显著降低,无论有无出口梗阻。自发性膀胱收缩使梗阻膀胱的膀胱壁灌注显著降低,但未梗阻膀胱则无此现象。在开放和闭合膀胱颈模型中,盆腔神经刺激均引起强烈的膀胱收缩,同时伴有膀胱壁灌注和膀胱氧合的显著下降。刺激腹下神经后变化不大。
膀胱扩张和收缩,尤其是在膀胱颈闭合的情况下,会导致膀胱壁显著缺血和缺氧。这些发现可能在多种常见临床问题的病理生理学中具有重要意义。