不同灌注速度及方法对大鼠膀胱容量、压力及神经传入电活动测定的影响

摘要

目的：探讨不同灌注速度及方法对大鼠膀胱容量、压力及神经传入电活动测定的影响。方法：SD雌性大鼠随机分为2组，分别选用尿道插管法及膀胱顶造瘘法，以50、100、200和400μL／min的速度进行灌注，以尿动力仪观察灌注过程中膀胱容量及压力的变化，以多通道生理记录仪检测灌注过程中膀胱神经传入电活动的变化。结果：采用插管法进行灌注测得最大放电频率，其随速度的升高呈上升趋势；膀胱漏尿点压（ BLPP ）和最大膀胱排尿压（ MVP）随着灌注速度的升高而增大；各灌注速度下膀胱最大容量（ MBC）无显著变化。造瘘法以各速度测得最大放电频率均无显著变化；其MBC随速度升高呈下降趋势，且在200及400μL／min灌注时显著降低；其BLPP及MVP无明显变化。2种方法相比，放电频率基线值无显著差异，以100、200和400μL／min进行灌注时造瘘法测得的膀胱最大放电频率均低于插管法；以不同速度灌注，造瘘法测得的MBC均比插管法小；而以50和100μL／min进行灌注时，造瘘法测得的压力比插管法高。结论：插管法以不同速度进行灌注并未对膀胱容量造成明显变化，但其膀胱压力及神经放电频率随速度升高，使用此法应根据研究目的选择灌注速度；采用造瘘法在200及400μL／min的灌注速度时，膀胱容量明显减少，故采用该法时建议以＜200μL／min的速度进行灌注。%AIM: To investigate the changes of bladder volume , pressures and pelvic nerve firing induce by different speeds and ways of instillation .METHODS:Female SD rats (n=20) were randomly divided into 2 groups.The rats in group A was performed using 3-F polyethylene tubing inserted into the bladder through the urethra .The rats in group B were performed using 3-F tubing inserted into the dome of the bladder and secured by silk suture .The rats in both groups were infused with saline into the bladder at different speeds of 50, 100, 200 and 400μL/min.The changes of bladder vol-ume and pressure were recorded by urodynamic measuring devices .The changes of pelvic nerve firing during instillation were recorded by multi-channel physiologic recorder .RESULTS:In group A, the maximum firing frequency , bladder leak point pressure ( BLPP) and maximum voiding pressure ( MVP) were increased with the increase in the instillation speed . No significant difference of the maximum bladder capacity (MBC) at different speeds was observed .In group B, the maxi-mum firing frequency had no significant difference at different speeds .MBC was decreased with the increase in the instilla-tion speed , and exhibited significant decrease at 200 and 400 μL/min.No significant difference of BLPP and MVP at dif-ferent speeds was observed .Compared with group A , the maximum firing frequency and MBC in group B significantly de-creased at different speeds .However , BLPP and MVP in group B were higher than those in group A at the speeds of 50 and 100 μL/min.CONCLUSION:Different instillation speeds with the method of group A will not change the bladder volume but influence the pelvic nerve firing , so the process of method A may take various speeds according to different aims .How-ever, process of method B at the speed of over 200 μL/min may not be good to MBC, thus instillation under 200 μL/min is re-commended .