摘要
目的:了解直肠阴道隔周围区域的断层形态结构,为妇产科、肛肠外科的相关区域病变提供可靠的解剖学依据。方法:成人尸体盆腔部标本10例,制成0.5mm厚的水平位火棉胶连续切片。结果:①直肠阴道隔的前面与阴道后壁紧贴而与直肠间空隙较大,从而导致直肠前壁的空虚,可视为直肠阴道间隙的前界。②通过在阴道后穹平面,宫颈口平面及阴道口平面的形态观察,发现直肠阴道隔呈上宽下窄,纤维组织逐渐致密的特点。直肠阴道隔的上端起自直肠子宫陷凹的底部,与阴道后壁紧贴,下端与会阴中心腱相融合。故直肠突出好发于直肠阴道隔上端。结论:直肠阴道隔是支持和悬吊直肠、阴道的关键性结构,也是维持盆腔稳定的关键因素。其上端最为薄弱,也是直肠前突最易好发的部位。修补直肠阴道隔时,也要修补松弛的会阴中心腱和周围的韧带结构等。
Objective： To study the section anatomical features of the rectovaginal septum （RVS）, and provide anatomic basis for treating gynecologic and anorectal diseases. Methods： 10 adult pelvic specimens were sliced into continuous transverse sections with the thickness of 0.5mm after treating with celloidin, and then, anatomic observation were performed and analyzed. Results： （1）The anterior surface of RVS closed to the posterior vaginal wall, which led to a wide anterior rectal space, therefore, RVS can be regarded as the anterior boundary of rectum vaginal space. （2） RVS gradually narrowed and compacted from up downward. The upper part of RVS began from the bottom of rectovaginai pouch and closed to the posterior vaginal wall, while the lower part of it reached the perineal central tendon and mixed to it, which is the anatomic reason why rectocele easily occurred at the upper part of RVS. Conclusions： RVS is the key structure not only to support the vagina and rectum, but also to keep stability of pelvic cavity, which is weak on the upper part. The repair operation of rectocele should be concerning with the repair of the perineal body and surrounding ligments.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2009年第6期663-664,667,共3页
Chinese Journal of Clinical Anatomy
基金
天津市自然科学基金项目资助(07JCZDJC0-7800)
