直肠系膜临床解剖学的研究与进展

发布时间：2018-05-01 04:11

本文选题：直肠 + 筋膜　；参考：《中国组织工程研究》2016年07期

【摘要】：背景:目前,对于直肠系膜的边界,及其周围的筋膜、盆腔间隙、神经走行和淋巴结分布尚有争论,各种新技术的发展也使得相关的解剖学研究有新的进展。目的:综述前人的研究,以描述直肠系膜相关的解剖学进展,并讨论其临床意义。方法:以"rectum;mesentery;fascia;space;nerve;lymph node,total mesorectal excision(TME),clinical anatomy"为关键词,检索PubM ed数据库中关于直肠系膜及其周围的筋膜、盆腔间隙、淋巴结分布及神经走行的研究,以筋膜及淋巴结分布为主。结果与结论:对于系膜、筋膜、神经和淋巴结的研究常通过新鲜或者冷冻的标本,采用传统盆部与会阴部解剖的方法进行。目前常采用CAAD(Computer-assisted anatomical dissection)技术将免疫染色和电脑成像结合起来。三维模型能很好地体现不同解剖结构间的相互关系,以及神经走行空间位置。直肠系膜前方是Denonvilliers筋膜,后方是直肠骶骨筋膜。直肠系膜盆内脏神经由骶神经前根发出,穿过骶前筋膜,骶前间隙进入神经筋膜层,根据腹膜分为上、下两部分。直肠系膜内的淋巴结后部及近腹膜反折部较多。关于直肠系膜及其周围结构的解剖关系仍有许多争议,明确这些问题可为临床实践工作提供客观指导依据。
[Abstract]:Background: at present, the boundaries of mesorectus and its surrounding fascia, pelvic space, nerve pathway and lymph node distribution are still controversial. The development of various new techniques has also led to new advances in anatomical research. Objective: to review the previous studies in order to describe the anatomical progress of mesorectum and discuss its clinical significance. Methods: taking "total mesorectal excisionation of mesentery fasciaspace" as the key word, we searched the PubM ed database for the study of fascia, pelvic space, lymph node distribution and nerve pathway in PubM ed database. The distribution of fascia and lymph nodes was mainly in fasciae and lymph nodes. Results & conclusion: the study of mesentery, fascia, nerve and lymph nodes is usually carried out by using traditional methods of pelvic and perineum anatomy. At present, CAAD(Computer-assisted anatomical dissection is often used to combine immunostaining with computer imaging. The three-dimensional model can well reflect the relationship between different anatomical structures and the space position of nerve walking. In front of the mesorectum is the Denonvilliers fascia and behind the rectosacral fascia. The pelvic splanchnic nerve of the mesorectus originates from the anterior root of the sacral nerve, passes through the sacral fascia, and enters the fascial layer of the nerve. According to the peritoneum, it is divided into two parts: the upper and the lower. There are more posterior lymph nodes and proximal peritoneal reflexes in mesorectus. There are still many controversies about the anatomical relationship between mesorectus and its surrounding structure, which can provide an objective basis for clinical practice.
【作者单位】：北京大学第二临床医学院;北京大学第三临床医学院;北京大学基础医学院人体解剖学与组织胚胎学系;
【基金】：北京大学医学交叉学科联合研究种子项目(BMU20140411) 国家基础科学人才培养基金资助项目(J1030831)~~
【分类号】：R322

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