泌尿神经系统电刺激及抑制作用机理研究

发布时间：2018-10-14 17:05

【摘要】：脊髓损伤发生以后,膀胱不能有效地储存尿液。由于逼尿肌的过度活动,膀胱不适症总会频繁的发生。由于逼尿肌和括约肌失调作用,膀胱不能很好的排空,从而在膀胱中会残留大量的尿液。大部分脊髓损伤患者通过人工导尿的方式来排空膀胱。然而,导尿和膀胱中残留的大量尿液可能导致膀胱的感染,而且膀胱长期的高压力可能导致各种严重的泌尿系统疾病。恢复脊髓损伤后膀胱的功能是一个很大的挑战,主要需要实现两方面的功能：一方面,在储尿期间,抑制膀胱逼尿肌的过度活动症；另一方面,在排尿期间,引起膀胱大幅度的收缩来尽可能多的排除尿液。为了解决上述两个问题,本论文主要做了以下工作： 1.测试通过控制一个无线、可植入的电刺激器发生的波形能否实现： 1)阻断阴部神经传导并且使尿道外括约肌处于放松状态； 2)促使一个大的、持续的膀胱收缩; 3)储尿阶段,抑制膀胱的反射活动,增大膀胱的储尿量。 2.在无髓鞘神经HH模型上,利用集总电路来研究高频双相非对称波形电刺激对于无髓鞘神经阻断的影响。 3.高频电刺激阻断神经传导后的恢复情况。研究结果表明： 1.该刺激器可以达到预期的效果,即抑制膀胱逼尿肌的过度活动,并且可以促使膀胱大幅度的收缩; 2.随着频率的增加,非对称波形和对称波形对于高频双相电刺激阻断神经传导的机制是不同的,由非对称高频电刺激引起的离子通道失活是阻断的机制； 3.高频电刺激阻断神经传导后,神经的传导功能是可恢复的,该恢复期与高频电刺激强度和时间有关,和频率无关。
[Abstract]:After spinal cord injury, bladder can not store urine effectively. Because of detrusor overactivity, bladder malaise always occurs frequently. Due to detrusor and sphincter disorders, the bladder can not be well emptied, resulting in a large amount of urine residue in the bladder. Most patients with spinal cord injury emptied their bladder by artificial catheterization. However, urinary catheterization and residual large amounts of urine in the bladder can lead to bladder infection, and long-term high bladder stress can lead to various serious urinary system diseases. Restoring bladder function after spinal cord injury is a major challenge that requires two main functions: on the one hand, to suppress the overactivity of the bladder detrusor during urinary storage, and, on the other hand, during urination. Causes the bladder to contract significantly to exclude as much urine as possible. In order to solve the above two problems, this paper mainly does the following work: 1. To test whether the waveform generated by controlling a wireless, implantable electrical stimulator can be achieved: 1) blocking the pudendal nerve conduction and relaxing the external urethral sphincter; 2) promoting a large, Continuous contraction of bladder, 3) inhibition of bladder reflex activity and increase of bladder urine storage. 2. 2. In the HH model of unmyelinated nerve, the effect of high frequency biphasic asymmetric waveform electrical stimulation on the blocking of unmyelinated nerve was studied by lumped circuit. Recovery after blocking nerve conduction by high frequency electrical stimulation. The results show that: 1. The stimulator can achieve the desired effect, that is, inhibit the excessive activity of the bladder detrusor muscle, and can promote a large contraction of the bladder; 2. With the increase of frequency, asymmetric and symmetrical waveforms are different in blocking nerve conduction by high-frequency biphasic electrical stimulation, and the ion channel inactivation caused by asymmetric high-frequency electrical stimulation is the blocking mechanism. 3. After high frequency electrical stimulation blocked nerve conduction, the nerve conduction function could be recovered. The recovery period was related to the intensity and time of high frequency electrical stimulation, and had nothing to do with frequency.
【学位授予单位】：北京交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R691

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