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find Author "朱爱祥" 2 results
  • EXPERIMENTAL STUDY ON ESTABLISHMENT OF PHYSIOLOGICAL MICTURITION REFLEX ARC FOR ATONIC BLADDER AFTER SPINAL CORD INJURY

    Objective To investigate the feasibil ity of establ ishment of physiological micturition reflex arc by simultaneously reconstructing the sensory and the motorial nerve of atonic bladder after spinal cord injury. Methods Eight 1-year-old Beegle male canine were selected, weighing 7-12 kg. The left side was the experimental side, while the right side wasthe control side. Epidural microanastomosis of vertebral canal of the left L7 ventral root to S2 ventral root and L7 dorsal root to S2 dorsal root was performed to reconstruct the sensory and the motorial function of atomic bladder. The right side was used as a control without treatment. The new motor-to-motor, and sensory-to-sensory physiological bladder reflex pathway were establ ished after 12 months of axonal regeneration. Then S1-4 segmental spinal cord was destroyed for preparation of complete paraplegia. The electrophysiological examination and the bladder pressure were detected before and after paraplegia. The canine micturition was observed for 3 months after paraplegia. Nurohistological observation was performed after canine sacrifice. Results Of 8 canine, 7 canine survived. After paraplegia, canines displayed urinary incontinence and frequent micturition at first, nocturnal continence was achieved gradually without frequent micturition after 1 month. Urinary infection at different degrees occurred in 3 canines and was controlled after Norfloxacin was administered orally. The bladder pressure increased to (1.00 ± 0.13) kPa, (0.90 ± 0.12) kPa after trains of stimulation (300 mV, 0.3 ms, 20 Hz, 5 seconds) of S2 dorsal root at the experimental side before and after paraplegia respectively, showing no significant difference (P gt; 0.05). It increased to (1.90 ± 0.10) kPa after the same train of stimulation of S2 dorsal root at control side. There was significant difference between the experimental side and the control side (P lt; 0.01). Single stimulation (300 mV, 0.3 ms) of the S2 dorsal root at the experimental side resulted in evoked potentials recorded from the left S2 ventral root before and after paraplegia. Before and after paraplegia, the ampl itudes of the evoked potentials were (0.68 ± 0.11) mV and (0.60 ± 0.08) mV respectively, showing no significant difference (P gt; 0.05). It was (1.21 ± 0.13) mV while stimulating at the control side. There was significant difference between the experimental side and the control side (P lt; 0.01). Neurofibra of L7 dorsal and ventral root grew into S2 dorsal and ventral root on tissue sl ice under l ight microscope. Conclusion Reconstruction of the bladder physiological micturition reflex arc is feasible by anastomosis of sacral dorsal and ventral root below injured spinal plane with the suprasacral survival dorsal and ventral root above the plane respectively for restoration of atonic bladder after spinal cord injury.

    Release date:2016-09-01 09:04 Export PDF Favorites Scan
  • 推进腓肠肌皮瓣修复跟腱开放性缺损

    目的 探讨跟腱开放性缺损的治疗方法及临床效果。 方法 2001 年5 月- 2008 年8 月,采用推进内外侧腓肠肌联合肌皮瓣治疗8 例外伤致跟腱开放性缺损。男5 例,女3 例;年龄15 ~ 36 岁,平均25 岁。左足3 例,右足5 例。伤后至手术时间为7 ~ 65 d。创面范围6.0 cm × 4.5 cm ~ 8.0 cm × 6.5 cm。跟腱缺损长度为5.0 ~ 7.5 cm,平均6.0 cm。术中肌皮瓣切取范围为22.5 cm × 7.8 cm ~ 28.0 cm × 11.5 cm,供区皮肤行V-Y 推进缝合。 结果 术后第2 天3 例肌皮瓣出现张力性水疱,经对症处理后成活;其余肌皮瓣均顺利成活,创面Ⅰ期愈合。供区切口Ⅰ期愈合。术后患者均获随访,随访时间6 个月~ 7 年,中位时间2 年3 个月。术后肌皮瓣质地、外观满意。末次随访时,按Arner-Lindholm跟腱损伤疗效评定标准,获优6 例,良2 例。 结论 内外侧腓肠肌联合肌皮瓣具有感觉、耐磨、对供区影响较小,是修复跟腱开放性缺损较理想的组织瓣。

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
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