The Animal Experiments And Clinical Data Analysis Of Bladder Urethral Dysfunction Caused By Spinal Cord Injury

Spinal cord injury (SCI) is the spinal cord function obstacle below the level of post-injury ,that due to various causes of spinal cord structure and function damage. The systemic complications of spinal cord injury (SCI) patients are more related to urinary, respiratory, circulatory, endocrine, psychological and other aspects. The renal failure caused by urinary bladder dysfunction' kidney damage is the leading cause of death on late SCI patients. We should have a very good development and application prospects in the urodynamic study of bladder and urethra dysfunction Caused By spinal cord injury.In this study involved in both clinical and basic research. The study includes the following five sections:Partâ… Research and produce the experimental device on preparation of standardized animal model of spinal cord injuryObjective:To Design and produce a kind of experimental device which can make standardized animal model of spinal cord injury. Product Description:The experimental devic including a bench, four rod, one vertical impact device, one sideswipe fighting unit and one vertical lifting device. The rod which composed of vertical and horizontal slider fixed in the experimental bench. The vertical impact device,the sideswipe fighting unit and the vertical lifting device were fixed on the rod respectively.Conclusion:The device can make single site injury in front of the spinal cord (ventral), posterior (dorsal), and a variety of different angles on both sides of the animal spinal cord,as well as make a variety of composite damage model.Partâ…¡Prepare and Validate the Standardized animal model of spinal cord injuryObjective:To certify ourself-designed experimental devices can prepared the standardized ventral and dorsal spinal cord injury animal model.Methods: Female SD rats of clean grade 74, 10 groups were randomly divided into three groups:(1) normal control group, 6 rats, (2) dorsal injury groups (divided into 6.25g/2cm, 6.25g/4cm, 6.25g/10cm,17g/2cm,17g/4cm and 17g/10cm total of six groups, each group 6-10 rats). (3) the ventral injury group (divided into 15g,30g,50g total of three groups, each group 6-8 rats). Animals in each group at 24h and 96h after injury to conduct behavioral assessments. The 5 days after injury, rats in each group randomly selected 2 rats, the injured spinal cord had been prepared the pathological section to observe the situation of spinal cord injuries.Results:When the drop height and the weight of crash bar is same ,the spinal cord injury rats with the basically same motor function and spinal cord dorsal structure damage;The impact of the same weight rod, if the drop height increases the spinal cord injury rats'motor function make worse and spinal cord dorsal structure damage aslo worse; The impact of the same drop height, if the rod weight increases the spinal cord injury rats'motor function make worse and spinal cord dorsal structure damage aslo worse also; when the drop height and the rod weight increases together spinal cord injury rats'motor function and spinal cord dorsal structure damage become worse too.During the course of prepare ventral spinal cord injury model,if the weight is same ,the rats has basically same motor function and spinal cord dorsal structure damage;if we increase the weight,the motor function and the spinal cord structural damage become worse.Conclusion:Our self-designed experimental device to prepare the standardized rat model of spinal cord dorsal and ventral spinal cord injury was successful.Partâ…¢Urodynamic assessment of Bladder function after spinal cord injury in ratsObjective:To observe the rats' bladder function changes while they have been injuried in the site on thoracolumbar or sacral dorsal spinal cord.Method:30 healthy female SD rats were divided into three groups, Group1:thoracolumbar spinal cord injury, 12 rats; Group2:sacral spinal cord injury 12 rats; groups3:control group, 6 rats. After they had been prepared to the spinal cord injury model,records the amount of urine when we squeeze the rats' abdomen.14 days later, all rats have urodynamic examination, and record the maximum bladder capacity, residual urine volume and bladder compliance.Results:During the anesthesia and spinal shock stage, the rats of thoracolumbar spinal cord injury group and the sacral spinal cord injury group all were urinary retention; while recovery from spinal shock, the bladder compliance of the thoracolumbar spinal cord injury rats become decreasing. The bladder changes of the sacral spinal cord injury rats is high compliance. The cases of maximum bladder capacity and residual urine volume increased in sacral spinal cord injury rat is more common than thoracolumbar spinal cord injury rat.Conclusion:There are difference changes in bladder compliance between the different sites of the spinal cord injury.The reason is that the different injury site cause the neural pathways damage is not same.Part IV The Urodynamic Analysis on spinal cord injury patients with urinary voiding dysfunctionObjective:To analyze the urodynamic test results of patients with spinal cord injury after the spinal cord shock period and find the differences of the bladder and urethra dysfunction between the sacral spinal cord injury and Thoracolumbar spinal cord injury.Method:Retrospective analysis the urodynamic test results of 30 cases spinal cord injury patients after spinal shock stage. According to patient imaging data ,they had been divided into sacral spinal cord injury group and thoracolumbar spinal cord injury group, we collected the clinical data of patients in general and the Urodynamic parameters. Comparing the results of these two groups.Results:The study found the urine volume by self-voided, residual urine volume, urine volume during cystometry, bladder compliance, there are differences between the two groups. The other urodynamic indicators are no significant differences between the two groups.we also find that the urine volume by self-voided and urine volume during cystometry between the two groups have a conflict conclusion. The difference of bladder and urethra functional changes between Sacral spinal cord injury and thoracolumbar spinal cord injuries are bladder compliance and bladder contractility changes.Conclusion:The urodynamics' difference between the sacral spinal cord injury group and thoracolumbar spinal cord injury group is bladder compliance and bladder detrusor contractility changes. But we can not assumpt the type of voiding dysfunction according to the injury site of spinal cord only. An accurate assessment of urinary bladder dysfunction of SCI patients need the urodynamics. And the premise of how to determine the relevant treatment is accurate assessment of bladder function status.Partâ…¤Construction of the urodynamic probability prediction model of the hydronephrosis in the spinal cord injury patientsObjective:To establish Logistic regression model to predict the probability of occurrence on the hydronephrosis in the spinal cord injury patients, and find the prediction tool for clinical interventions.Methods:Retrospective study the 30 cases clinical data of thoracolumbar and sacral spinal cord injury patients. The clinical date in general case and urodynamic urodynamic parameters had been collect. We had analyzed these parameters variable by the statistical principal component analysis then constructed the Logistic regression equation.Results:There are 4 principal components in the 12 index of the urodynamics numeric type parameters. By the single-factor logistic screening, found that only indicators of bladder compliance is the suitable indicator. We use the method of Logistic regression analysis, and get the logistic regression equation that predict the probability of occurrence on the hydronephrosis in the thoracolumbar and sacral spinal cord injury patients.Conclusions:Our study constructe the logistic regerssion model can predict the occurrence of hydronephrosis in the spinal cord injury patients.