本文選題：膀胱出口梗阻 + 低順應(yīng)性�。� 參考：《天津醫(yī)科大學(xué)》2010年碩士論文

【摘要】： 目的： 通過兔膀胱出口部分梗阻的辦法,建立低順應(yīng)性膀胱動(dòng)物模型,觀察梗阻后至低順應(yīng)性膀胱形成的過程中膀胱重量、膀胱容量、逼尿肌漏尿點(diǎn)壓力及順應(yīng)性的變化,研究其發(fā)展變化的機(jī)制和重要環(huán)節(jié),以期在膀胱功能發(fā)生不可逆改變之前,緩解膀胱出口梗阻后膀胱儲(chǔ)尿功能的改變。 方法： 28只雄性新西蘭兔隨機(jī)分成3組：對(duì)照組8只(A組),梗阻5周組10只(B組),梗阻14周組10只(C組)。梗阻5周組和14周組用相同手術(shù)方法建立膀胱出口部分梗阻模型：取恥骨上正中切口,游離膀胱頸,避開膀胱兩側(cè)韌帶內(nèi)的血管,鈍性游離膀胱頸,以2-0絲線自后方帶出結(jié)扎膀胱頸。對(duì)照組只做游離,不結(jié)扎。梗阻5周組于5周時(shí)進(jìn)行尿動(dòng)力學(xué)檢測(cè),C組分別于8周、12周、14周進(jìn)行尿動(dòng)力學(xué)檢測(cè),各組檢測(cè)完成后處死并留取膀胱標(biāo)本,常規(guī)HE染色觀察膀胱壁平滑肌,纖維結(jié)締組織變。 結(jié)果： 膀胱重量梗阻5周組(16.9±4.4)g,梗阻14周組膀胱重量(14.1±2.3)g,明顯高于對(duì)照組(2.7±0.5)g,均有統(tǒng)計(jì)學(xué)差異(P0.01)。 膀胱容量梗阻5周(67.0±17.3)ml、梗阻8周(57.8±16.9)ml與對(duì)照組(36.3±14.7)m1相比顯著增加(P0.01),梗阻后14周膀胱容量(20.9±6.2)ml小于對(duì)照組,有統(tǒng)計(jì)學(xué)差異(P0.05)。梗阻12周、14周膀胱容量與梗阻5周、8周相比顯著減少(P0.01)。 膀胱順應(yīng)性梗阻5周(5.16±1.41)m1／cmH2O、梗阻8周(4.39±1.72)cm／H2O與對(duì)照組(2.91±0.71)ml／cmH2O比明顯升高(P0.01,P0.05),梗阻12周膀胱順應(yīng)性(1.53±0.49)ml／cmH2O低于對(duì)照組(P0.05),梗阻14周組膀胱順應(yīng)性(1.21±0.44)ml／cmH2O與對(duì)照組比顯著下降(P0.01)。 結(jié)論： 通過兔膀胱頸不全結(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。膀胱出口梗阻14周后膀胱順應(yīng)性明顯下降,低順應(yīng)性膀胱建立成功。 膀胱出口梗阻5周、8周、12周、14周后膀胱結(jié)構(gòu)和功能發(fā)生了不同程度的改變：膀胱重量顯著增加,逼尿肌漏尿點(diǎn)壓逐漸增加,膀胱容量先增加后明顯減少,膀胱順應(yīng)性呈現(xiàn)先增高后降低的趨勢(shì)。
[Abstract]:Objective: to establish an animal model of low compliance bladder by using the method of partial bladder outlet obstruction in rabbits, and to observe the bladder weight and bladder capacity during the process of bladder formation from obstruction to low compliance. The changes of detrusor leakage point pressure and compliance were studied to study the mechanism and important link of detrusor leakage point pressure and compliance in order to alleviate the change of bladder urine storage function after bladder outlet obstruction before the irreversible change of bladder function. Methods: Twenty-eight male New Zealand rabbits were randomly divided into three groups: control group (n = 8), obstruction group (n = 10), obstruction group (n = 10) and group C (n = 10). The model of bladder outlet partial obstruction was established in the 5th and 14th week groups with the same surgical method: the suprapubic median incision, the free bladder neck, avoiding the vessels in the ligaments of both sides of the bladder, and the blunt free bladder neck. The bladder neck was ligated with 2-0 thread from the rear. In the control group, only free, no ligation. Urodynamic examination was performed in group C at 5 weeks after obstruction. The bladder specimens were sacrificed and collected after 8 weeks and 12 weeks and 14 weeks respectively. The smooth muscle of bladder wall and connective tissue were observed by routine HE staining. Results: the weight of bladder in 5 weeks group and 14 week group was (16.9 鹵4.4) g and (14.1 鹵2.3) g respectively, which was significantly higher than that in control group (2.7 鹵0.5) g (P0.01). The bladder volume at 5 weeks after obstruction (67.0 鹵17.3) ml and at 8 weeks (57.8 鹵16.9) ml was significantly higher than that in the control group (36.3 鹵14.7) ml (P0.01). The bladder volume at 14 weeks after obstruction was (20.9 鹵6.2) ml lower than that in the control group (P0.05). The bladder volume at 12 and 14 weeks after obstruction was significantly lower than that at 5 and 8 weeks after obstruction (P0.01). Bladder compliance was (5.16 鹵1.41) ml / cm H _ 2O at 5 weeks and (4.39 鹵1.72) cm / h _ 2O at 8 weeks after obstruction compared with (2.91 鹵0.71) ml / cm H _ 2O in control group (P 0.05). At 12 weeks of obstruction, bladder compliance was (1.53 鹵0.49) ml / cm H _ 2O lower than that in control group (P0.05), and bladder compliance was (1.21 鹵0.44) ml 路cmH _ 2O lower than that in control group at 14 weeks (P0.01). Conclusion: the Boo animal model established by incomplete ligation of bladder neck in rabbits has the advantages of simple method, high survival rate and good stability. It is suitable for the experimental study of bladder outlet obstruction. After 14 weeks of bladder outlet obstruction, bladder compliance decreased significantly, and low compliance bladder was successfully established. After 5 weeks, 8 weeks, 12 weeks and 14 weeks of bladder outlet obstruction, the bladder structure and function changed to different degrees: bladder weight increased significantly, detrusor leakage point pressure increased gradually, bladder capacity increased first and then decreased significantly. Bladder compliance increased first and then decreased.
【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】：2010
【分類號(hào)】：R-332

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 劉南,宋波,金錫御,熊恩慶;大鼠梗阻性低順應(yīng)性膀胱的組織結(jié)構(gòu)改變[J];第三軍醫(yī)大學(xué)學(xué)報(bào);2002年09期

2 宋波,金錫御;膀胱下尿路梗阻的尿流動(dòng)力學(xué)分析(尿流動(dòng)力學(xué)系列講座之三)[J];臨床泌尿外科雜志;1998年12期

3 周德榮,章振保;大鼠膀胱出口梗阻模型的建立及其尿動(dòng)力學(xué)檢測(cè)[J];汕頭大學(xué)醫(yī)學(xué)院學(xué)報(bào);2004年03期

4 吳永安，李麗華，李樹倫，鄧昕，候旭，黃金海;前列腺增生癥的逼尿肌功能觀察[J];中華泌尿外科雜志;1995年11期

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];中國協(xié)和醫(yī)科大學(xué);2007年

，

本文編號(hào)：2062117