本文選題：直腸 + 筋膜��； 參考：《中國組織工程研究》2016年07期

【摘要】：背景:目前,對于直腸系膜的邊界,及其周圍的筋膜、盆腔間隙、神經(jīng)走行和淋巴結(jié)分布尚有爭論,各種新技術(shù)的發(fā)展也使得相關(guān)的解剖學(xué)研究有新的進(jìn)展。目的:綜述前人的研究,以描述直腸系膜相關(guān)的解剖學(xué)進(jìn)展,并討論其臨床意義。方法:以"rectum;mesentery;fascia;space;nerve;lymph node,total mesorectal excision(TME),clinical anatomy"為關(guān)鍵詞,檢索PubM ed數(shù)據(jù)庫中關(guān)于直腸系膜及其周圍的筋膜、盆腔間隙、淋巴結(jié)分布及神經(jīng)走行的研究,以筋膜及淋巴結(jié)分布為主。結(jié)果與結(jié)論:對于系膜、筋膜、神經(jīng)和淋巴結(jié)的研究常通過新鮮或者冷凍的標(biāo)本,采用傳統(tǒng)盆部與會(huì)陰部解剖的方法進(jìn)行。目前常采用CAAD(Computer-assisted anatomical dissection)技術(shù)將免疫染色和電腦成像結(jié)合起來。三維模型能很好地體現(xiàn)不同解剖結(jié)構(gòu)間的相互關(guān)系,以及神經(jīng)走行空間位置。直腸系膜前方是Denonvilliers筋膜,后方是直腸骶骨筋膜。直腸系膜盆內(nèi)臟神經(jīng)由骶神經(jīng)前根發(fā)出,穿過骶前筋膜,骶前間隙進(jìn)入神經(jīng)筋膜層,根據(jù)腹膜分為上、下兩部分。直腸系膜內(nèi)的淋巴結(jié)后部及近腹膜反折部較多。關(guān)于直腸系膜及其周圍結(jié)構(gòu)的解剖關(guān)系仍有許多爭議,明確這些問題可為臨床實(shí)踐工作提供客觀指導(dǎo)依據(jù)。
[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.
【作者單位】： 北京大學(xué)第二臨床醫(yī)學(xué)院;北京大學(xué)第三臨床醫(yī)學(xué)院;北京大學(xué)基礎(chǔ)醫(yī)學(xué)院人體解剖學(xué)與組織胚胎學(xué)系;
【基金】：北京大學(xué)醫(yī)學(xué)交叉學(xué)科聯(lián)合研究種子項(xiàng)目(BMU20140411) 國家基礎(chǔ)科學(xué)人才培養(yǎng)基金資助項(xiàng)目(J1030831)~~
【分類號】：R322

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