直肠阴道隔的解剖学研究及其临床意义  

The anatomy of the rectovaginal septum and its clinical significance

作　　者：翟丽东[1] 刘瑾[1] 袁武[1] 刘万祥[1] 黄三合[1] 何路[1] 李云生[1] 

机构地区：[1]天津医科大学解剖学教研室,天津300070

出　　处：《中国临床解剖学杂志》2009年第4期405-407,共3页Chinese Journal of Clinical Anatomy

基　　金：天津市自然科学基金重点项目(07JCZDJC07800)

摘　　要：目的:为直肠癌切除术,阴道塌陷及影像学提供解剖学依据。方法:25例福尔马林固定的成年女性盆腔标本,14例行正中失状切,在体式镜下观察,11例制成250～750μm厚的水平和矢状位火棉胶切片。结果:直肠阴道隔由前后两层组成,前层是Denonvilliers'fascia,后层是直肠固有筋膜。二者紧贴在一起,向上在直肠子宫陷凹处的腹膜折返下方分开,向下在会阴体上方分开,两侧在阴道后外侧分开。Denonvilliers'fascia在不同水平其两侧的止点不同:在宫颈平面止于宫旁组织,在阴道上部止于阴道旁组织,在阴道中部止于盆筋膜腱弓,在阴道下部止于肛提肌出口的外侧。结论:直肠阴道隔由前方的Denonvilliers'fascia和后方的直肠固有筋膜组成。Objective： To provide anatomic data of the rectovaginal septum for the treatment of rectal cancer and vaginal prolape. Methods： 25 antiseptic pelvic specimens of adult female were used in this study. 14 specimens were made sagittal sections and observed under anatomical microscopy, while aother 11 were embedded by celloidin and made into successive slices with the thickness of 250-750um. Results： The rectovaginal septum composed of anterior and posterior layers. The anterior layer was Denonvilliers＇ fascia, and the posterior layer the fascia propria of rectum. The two layers closely sticked together, and divided superiorly at the reflection of peritoneum of the rectouterine pouch, inferiorly at the upside of the perineal body, laterally at the posterolateral side of vagina. The insertions of Denonvilliers＇ fascia were different at different levels： at the cervix, Denonvilliers＇ fascia merged into parametrium; at the upper vagina, it ended laterally at paracolpium; at the middle vagina, it anchored to the arcus tendineus fasciae pelvis; at the lower vagina, it ended at the lateral side of the levator ani muscles＇ outlet. Conclusions： The rectovaginal septum forms by Denonvilliers＇ fascia and the fascia propria of rectsum.

关 键 词：直肠阴道隔 Denonvilliers’fascia 直肠固有筋膜 盆筋膜腱弓 火棉胶 

分 类 号：R323.5[医药卫生—人体解剖和组织胚胎学]