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脊髓損傷犬에서 仙椎神經根의 電氣刺戟이 膀胱收縮에 미치는 反應

Effects of sacral root stimulation on the cord bladder

경북의대잡지 1974년 15권 2호 p.43 ~ 51
김승래,
소속 상세정보
김승래 (  ) - 경북대학교 의과대학 외과학교실

Abstract


Care of the cord bladder still constitutes one of the most challenging aspects in the treatment of the paraplegia. To improve the bladder function, several methods of the bladder evacuation induced by electrical stimulation of the spinal cord, pelvic nerve or detrusor muscle have been investigated.
The author studied the effects of electrical stimulation of the sacral root (20Hz, 20msec, 10v. for 15 sec) on the cord bladder in dogs and the following results were obtained.
1. The stimulation of the 2nd and 3rd sacral root either separately or simultaneously, before or after cord injury resulted in an elevation of intravesical pressure sufficient for micturition and the response to the right side stimulation was much greater than that of the left. It was suggested that the 2nd and 3rd sacral roots would be mainly reponsible for micturition in the do.
2. On the stimulation of the 2nd and 3rd sacral root separately or simultaneously, in cord injured dogs, the intravesical pressure of the urinary bladder located in the abdominal cavity was slightly higher than that exposed out of the abdominal cavity.
3. In 4 among 5 cord injured dogs, the bladder evacuated over a half to two thirds of its contents when right 2nd and 3rd sacral roots were stimulated.
4. Fluoroscopic findings showed bilateral contraction of the bladder without ureteral reflux, distended proximal urethra and contraction at the external sphincter region when right side of the 2nd and 3rd sacral roots were stimulated simultaneously.
5. Cardiopulmonary changes, mean arterial flood pressure, heart rate and respiration induced by right side stimulation of the 2nd and 3rd sacral roots in paraplegic dogs were not significant throughout the procedures. During the period of stimulation, however, slight transient respiratory irregularities were observed and heart rates were 30 to 40 beats per minute faster than without stimulation.

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