發(fā)布時(shí)間：2018-05-26 20:59

  本文選題：膀胱出口梗阻 + 順應(yīng)性　； 參考：《天津醫(yī)科大學(xué)》2009年碩士論文

【摘要】：目的： 通過(guò)建立兔膀胱出口梗阻的動(dòng)物模型,觀察梗阻后膀胱壁組織結(jié)構(gòu)和膀胱順應(yīng)性的變化,研究其病理生理發(fā)展變化的機(jī)制和關(guān)鍵環(huán)節(jié)。探討多沙唑嗪(doxazosin)對(duì)梗阻后膀胱形態(tài)和膀胱功能的影響,以期可以找到合適的干預(yù)點(diǎn)來(lái)解除或緩解膀胱出口梗阻后膀胱壁纖維化和膀胱的低順應(yīng)性。 方法： 36只雄性新西蘭兔隨機(jī)分成4組：A組9只為對(duì)照組,B組9只為梗阻組,C組9只為梗阻加用多沙唑嗪組,D組9只為對(duì)照加用多沙唑嗪組。B組和C組均手術(shù)建立膀胱出口部分梗阻模型,方法相同。對(duì)照組只做游離,不結(jié)扎。手術(shù)后5周對(duì)4組進(jìn)行尿動(dòng)力學(xué)檢測(cè),檢測(cè)完成后留取膀胱標(biāo)本,常規(guī)HE染色觀察膀胱出口梗阻后膀胱壁形態(tài)學(xué)變化。 結(jié)果： 5周后膀胱出現(xiàn)了典型的梗阻表現(xiàn)：梗阻組及梗阻后應(yīng)用多沙唑嗪組的膀胱重量分別為(16.9±4.4)g和(8.9±5.9)g,均明顯重于對(duì)照組的(2.7±0.5)g,P0.01。梗阻后應(yīng)用多沙唑嗪組與梗阻組相比,膀胱重量明顯減輕,P0.01。梗阻組膀胱容量為(64.0±24.5)ml,明顯大于對(duì)照組(29.3±10.4)ml,P0.01,梗阻后服用多沙唑嗪組膀胱容量為(42.2±19.0)ml,與梗阻組相比減小,P0.05。梗阻組膀胱漏尿點(diǎn)壓為(29.3±11.5)cmH2O,明顯高于對(duì)照組(16.5±3.6)cmH2O,P0.01,梗阻后服用可多華組(15.2±2.8)cmH2O,與梗阻組相比明顯減低,P0.01。梗阻組與對(duì)照組膀胱順應(yīng)性分別為(5.53±4.41)和(2.46±1.03)ml/cmH2O,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。光鏡觀察到兔膀胱出口梗阻后,平滑肌增生肥大,肌束間膠原纖維浸潤(rùn)顯著增多,梗阻后加用多沙唑嗪可以減輕膀胱壁增厚程度。結(jié)論： (1)通過(guò)兔膀胱頸不全結(jié)扎法建立的BOO實(shí)驗(yàn)動(dòng)物模型具有方法簡(jiǎn)便、存活率高、穩(wěn)定性好等特點(diǎn),適用于膀胱出口梗阻的相關(guān)實(shí)驗(yàn)研究。 (2)膀胱出口梗阻5周后膀胱結(jié)構(gòu)和功能發(fā)生了改變：膀胱重量顯著增加,膀胱容量明顯增加；光鏡觀察到逼尿肌肥大,肌束間膠原纖維浸潤(rùn)顯著增多。 (3)多沙唑嗪可使降低膀胱出口梗阻后膀胱重量和容量的增加程度,改善梗阻后膀胱壁平滑肌血供,降低膀胱漏尿點(diǎn)壓,保護(hù)膀胱功能,延緩膀胱出口梗阻后膀胱失代償?shù)倪M(jìn)展。
[Abstract]:Objective: By establishing an animal model of bladder outlet obstruction in rabbits, the changes of bladder wall structure and bladder compliance after obstruction were observed, and the mechanism and key links of its pathophysiological development were studied. To investigate the effect of doxazosin on bladder morphology and bladder function after obstruction, we hope to find a suitable intervention point to relieve or relieve bladder wall fibrosis and bladder low compliance after bladder outlet obstruction. Methods: 36 male New Zealand rabbits were randomly divided into 4 groups: control group (n = 9), obstruction group (n = 9), doxazosin group (n = 9), control group (n = 9), doxazosin group (n = 9) and group C (n = 9). Outlet partial obstruction model, The method is the same. In the control group, only free, no ligation. Five weeks after operation, the urodynamics of the four groups were examined, and the bladder specimens were collected after the detection. The morphological changes of bladder wall after bladder outlet obstruction were observed by routine HE staining. Results: After 5 weeks, typical bladder obstruction appeared: the weight of bladder in obstruction group and doxazosin group were 16.9 鹵4.4 g and 8.9 鹵5.9 g, respectively, which were significantly higher than that in control group (2.7 鹵0.5g / g). The weight of bladder in doxazosin group was significantly lower than that in obstruction group (P 0.01). The bladder capacity in the obstruction group was 64.0 鹵24.5ml, which was significantly higher than that in the control group (29.3 鹵10.4ml). After obstruction, the bladder capacity of the group treated with doxazosin was 42.2 鹵19.0ml, which was lower than that of the control group (P 0.05). The urinary leakage point pressure of the obstruction group was 29.3 鹵11.5cm H _ 2O, which was significantly higher than that of the control group (16.5 鹵3.6g 路h _ 2O) P 0.01. after the obstruction, the bladder leakage point pressure was 15.2 鹵2.8 cm _ H _ 2O, which was significantly lower than that in the obstruction group. The bladder compliance was 5.53 鹵4.41 in the obstruction group and 2.46 鹵1.03ml / cm H _ 2O in the control group. The difference was statistically significant (P < 0.05). It was observed by light microscope that the smooth muscle proliferated and hypertrophy and the infiltration of collagen fibers between muscle bundles increased significantly after bladder outlet obstruction in rabbits. Adding doxazosin to the bladder wall after obstruction could reduce the thickness of bladder wall. Conclusion: 1) the BOO experimental animal model established by incomplete ligation of bladder neck in rabbits has the advantages of simple method, high survival rate and good stability, which is suitable for the experimental study of bladder outlet obstruction. 2) after 5 weeks of bladder outlet obstruction, the structure and function of bladder were changed: the weight of bladder increased significantly, the volume of bladder increased, and the detrusor hypertrophy and the infiltration of collagen fibers between muscle bundles were observed under light microscope. Doxazosin can reduce the increase of bladder weight and volume after bladder outlet obstruction, improve the blood supply of bladder wall smooth muscle, reduce bladder leakage point pressure, protect bladder function and delay the progress of bladder decompensation after bladder outlet obstruction.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類(lèi)號(hào)】：R-332;R694

【參考文獻(xiàn)】

相關(guān)博士學(xué)位論文 前1條

1 張學(xué)斌;下尿路梗阻膀胱形態(tài)與機(jī)能的基礎(chǔ)和臨床研究[D];中國(guó)協(xié)和醫(yī)科大學(xué);2007年

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本文編號(hào)：1938878