分娩期子宫下段肌层显微超微结构变化的研究  

Changes in microstructure and ultrastructure of myometrium of the lower uterine segment in course of cervical dilation during term parturition

作　　者：李斌[1] 柯丽娜[1] 李金范[1] 邹万忠[2] 

机构地区：[1]湖北省郧阳医学院附属东风医院,湖北十堰442008 [2]北京大学医学部,北京100083

出　　处：《中国妇幼健康研究》2007年第2期101-103,I0001,I0002,共5页Chinese Journal of Woman and Child Health Research

基　　金：湖北省教育厅青年基金资助项目(2001.B39003)

摘　　要：目的观察分娩期宫颈不同扩张程度下子宫下段肌层显微结构及超微结构的变化,探讨宫颈扩张机制。方法用光镜和电镜观察宫颈不同扩张程度下子宫下段肌层组织的显微结构和超微结构的变化,并用免疫组化SP法观察中性粒细胞和巨噬细胞在子宫下段肌层组织上的表达情况。结果随着宫颈口的扩张,平滑肌组织中的血管逐渐出现扩张、充血和出血,中性粒细胞和组织细胞由血管周围浸润发展至组织内弥漫浸润;胶原纤维网逐渐出现溶解消失。免疫组化结果显示中性粒细胞和巨噬细胞在C、D组平滑肌组织间和血管周围的细胞数目明显增多,呈弥漫性浸润,明显高于A组和B组(P<0.01,P<0.01)。结论该研究结果表明:①宫颈扩张过程呈现一种类急性炎症反应过程;②随着宫颈的扩张,子宫下段组织中的胶原纤维网逐渐出现溶解和消失,阐明了分娩过程中人类子宫下段肌层的组织学变化。Objective To observe changes in microstructure and ultrastructure of the lower uterine segment in course of varied degrees of cervical dilation during term parturition so as to explore mechanism of cervical dilation. Methods Biopsy specimens were taken from the lower uterine segment of 40 women undergoing cesarean section at term in different stages of cervical dilation. The changes in microstructure and ultrastructure of muscular tissues of the lower uterine segment in varied degrees of cervical dilation during delivery were observed with light microscope and transmission electron microscope. The expressions of neutrophils and macrophages in the muscular tissues of the lower uterine segment were detected using immunohistochemical SP method. Results With course of dilation of the cervical orifice, the smooth muscle tissues of the lower uterine segment presented gradual angiectasis, congestion and hemorrhage, the neutrophils and macrophages infiltrating and disfusing from the surrounding of the vessels into the muscular tissues, dissolved and disappeared collagenous fiber network. The immunohistochemical analysis showed that the numbers of neutrophil and macrophage significantly increased in C, D subgroups of the smooth muscle tissue space and the surrounding of the vessels, and presented disused infiltration, which was higher significantly than those in the subgroup A and subgroup B（P 〈0.01, P 〈0.01 ）. Conclusion （~） In course of dilation, the cervix presents an acute inflammatory reaction; ~） With dilation of the cervical orifice, the collagenous fiber network in the myometrium of the lower uterine segment are dissolved gradually in order to adapt to a puerperal demand, which expounds the histological changes of the human lower uterine segment in course of term parturition.

关 键 词：分娩 子宫颈 显微结构 超微结构 白细胞 

分 类 号：R714[医药卫生—妇产科学]