腹盆腔段输尿管及其周围结构的数字化解剖研究

doi:10.13418/j.issn.1001-165x.2019.04.006

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (4): 386-389.doi: 10.13418/j.issn.1001-165x.2019.04.006

腹盆腔段输尿管及其周围结构的数字化解剖研究

郑丽梅 ¹，玉洪荣 ²，徐晓武³，潘智越³，李严兵 ¹，黄文华 ¹

1.南方医科大学解剖学教研室，广东省医学 3D 打印应用转化工程技术研究中心，广东省医学生物力学重点实验室，广州 510515； 2.广西医科大学基础医学院，南宁 530021； 3.南方医科大学第五附属医院，广州 510900

收稿日期:2019-03-11 出版日期:2019-07-25 发布日期:2019-08-01
通讯作者: 黄文华，教授，博士生导师， E-mail： Huangwenhua2009@139.com
作者简介:郑丽梅（1992-），女，福建人，在读硕士，研究方向：数字医学在妇产科中应用， E-mail： 924104544@qq.com
基金资助:
国家重点研发计划（2017YFC1103403）；广东省科技计划项目（2016B090917001， 2016B090913004， 2017B090912006）；广州市科技计划（201707010066）

Digital three-dimensional anatomy of abdominopelvic ureter and adjacent structures

ZHENG Li-mei¹, YU Hong-rong², XU Xiao-wu³, PAN Zhi-yue³, LI Yan-bing¹, HUANG Wen-hua¹

1. Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Cuangdong Provincial key laboratory of Medical Biomechanics Department of Anatomy, Southern Medical University, Guangzhou 510515; 2. School of Preclinical Medicine, Guangxi Medical University, Guangxi 530021; 3. The Fifth Affiliated Hospital of Southern Medical University, Guangzhou 510900, China

Received:2019-03-11 Online:2019-07-25 Published:2019-08-01

摘要/Abstract

摘要： 目的　探讨输尿管腹盆腔段与周围结构的解剖学特征，为广泛性子宫切除术中安全游离输尿管提供解剖学依据。方法　收集2017年4月至2018年12月女性盆腔CTA数据65例，对盆部动脉、输尿管、子宫进行三维重建，测量输尿管到盆腔动脉、子宫的间距，观察输尿管腹盆段与周围结构的毗邻关系。结果　输尿管跨越髂动脉有3种类型：左侧：髂总动脉（33.84%）、髂总动脉分叉处（13.85%）、髂外动脉（55.38%）；右侧：髂总动脉（27.69%）、髂总动脉分叉处（20.00%）、髂外动脉（52.30%）。“输尿管隧道”入口处对应宫颈旁占66.15%，输尿管进入膀胱处对应阴道占70.7%。腹主动脉分叉处与输尿管间距：左侧（32.45±6.24）mm，右侧（39.3±5.78）mm；髂总动脉分叉处与输尿管间距：左侧（10.55±4.85）mm，右侧（13.34±5.49）mm；输尿管隧道入口处与宫体间距：左侧（16.94±6.83）mm，右侧（18.11±6.53）mm；输尿管与宫颈内口外侧缘间距：左侧（19.26±7.62）mm，右侧（22.5±7.41）mm；输尿管与宫颈外口外侧缘间距左侧（17.06±6.19）mm，右侧（22.49±4.94）mm。以上左右两侧的比较均具有统计学差异（P<0.05）。结论　熟悉腹盆段输尿管与周围结构的解剖关系，对广泛性全子宫切除术中预防输尿管损伤十分重要。

关键词: 输尿管, 三维重建, 腹盆腔动脉, 宫颈段, 解剖测量

Abstract: Objective　To provide the anatomic basis for ureteral dissociation in radical hysterectomy by studying the anatomical characters of ureter in abdominopelvic cavity.　Methods　The CTA data of 65 female pelvic patients were collected from Apr.2017 to Dec.2018. Through the 3D reconstruction with ureters, pelvic artery and uterus, the pathway of abdominopelvic ureters was observed. We measured the distance from the ureter to the pelvic artery and the ureter to uterus, then observed the adjacent structures around ureters. Results　There were three types of the iliac artery across the ureter. On the left side, the common iliac artery (33.84%), the bifurcation of common iliac artery (13.85%) and the external iliac vein (55.38%) crossed with the ureter; on the right side, the common iliac artery (27.69%) the bifurcation of the common iliac artery (20.00%), and the external iliac vein (52.30%) crossed with the ureter. The entrance of the “ureteric tunnel” corresponded to the cervix (66.15%) and the entrance of the ureter into the bladder corresponded to the vagina (70.7%). The distance between the bifurcation of the abdominal aorta and the ureter was (32.45±6.24) mm on the left and (39.3±5.78) mm on the right. The distance between the bifurcation of the common iliac artery and the ureter was (10.55±4.85) mm on the left and (13.34±5.49) mm on the right. The distance between the ureteric tunnel entrance and the uterine was (16.94±6.83) mm on the left and (18.11±6.53) mm on the right. The distance between the ureter and the lateral margin of the inner cervical was (19.26±7.62) mm on the left and (22.5±7.41) mm on the right. The distance between the ureter and the lateral margin of the external cervical was (17.06±6.19) mm on the left and (22.49±4.94) mm on the right. There were statistical differences between the above mentioned two sides (P<0.05).　Conclusion　These findings provide novel and important references to the anatomic relationship of the ureter in abdominopelvic cavity and adjacent structures. It may help surgeons reduce the risk of ureteric injury in radical hysterectomy.

Key words: Ureter, 3D reconstruction, Abdominal pelvic artery, The cervical segment; Anatomical measurement

中图分类号:

R713.4

郑丽梅, 玉洪荣, 徐晓武, 潘智越, 李严兵, 黄文华 . 腹盆腔段输尿管及其周围结构的数字化解剖研究[J]. 中国临床解剖学杂志, 2019, 37(4): 386-389.

ZHENG Li-mei, YU Hong-rong, XU Xiao-wu, PAN Zhi-yue, LI Yan-bing, HUANG Wen-hua. Digital three-dimensional anatomy of abdominopelvic ureter and adjacent structures[J]. Chinese Journal of Clinical Anatomy, 2019, 37(4): 386-389.

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腹盆腔段输尿管及其周围结构的数字化解剖研究

Digital three-dimensional anatomy of abdominopelvic ureter and adjacent structures

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