经阴道广泛性子宫切除术中自宫颈支持韧带的应用解剖  

Applied Anatomy of Suporting Ligaments of Cervix Uteri in Radical Vaginal Hysterectomy

作　　者：符泽美 汪坤菊[2] 陈敏[2] 林威威[2] 

机构地区：[1]海南省海口市中医院,海口570102 [2]海南医学院解剖学教研室,海口570102

出　　处：《四川解剖学杂志》2014年第1期4-6,61,共3页Sichuan Journal of Anatomy

基　　金：海南省卫生厅基金(琼卫2009-51)

摘　　要：目的为经阴道广泛性子宫切除术提供应用解剖学基础。方法经阴道逆行解剖观测8例(16侧)常规防腐女性盆腔尸体标本。结果 (1)膀胱宫颈韧带位于膀胱、子宫颈和阴道之间,可分为宫颈部(2.10±0.85)cm、阴道部(1.70±0.61)cm;膀胱宫颈韧带长度为(4.10±1.05)cm,输尿管膝部距离子宫动脉跨越处(2.14±0.40)cm。(2)输尿管穿过子宫主韧带,距子宫颈(1.71±0.22)cm,其上方有子宫动脉和静脉。(3)子宫骶韧带的颈部、中间部、骶骨部距离输尿管的长度为(0.82±0.50)cm、(2.42±0.81)cm和(4.00±0.71)cm。结论经阴道广泛性子宫切除术中对起自宫颈的三对韧带的应用解剖了解非常重要,可避免损伤输尿管和子宫动脉等重要结构。Objective This survey was made to explore the vesicocervical ligament and provide anatomic basis for radicalvaginal hysterectomy. Methods A total of 16 female cadaveric hemi-pelvis were dissected from vagina to uterus. Results （1）The vesicocervical ligament linked the bladder to the cervix and the supravaginal portion, which can be divided into cervical part with the length of （2.10±0.85） cm and vaginal part of （1.70±0.61） cm; The length of thevesicocervical ligament was about （4.10±1.05）cm ; The distance from ureter to the entrance of the uterine artery was about （2.14±0.40） cm. （2） The ureter went straight through cardinal ligament; The distance from ureter to the entrance of the cervix was about（1.71±0.22）cm （3） The utero sacral ligament was divided into three segments： the cervical portion, intermediate portion, and sacral portion. The distance from the ureter to utero sacral ligament was（0.82±0.50）cm, （2.42±0.81） cm, （4.00±0.71） cm in the cervical. Conclusion The dissection of the vesicocervical ligament is important during the radicalvaginal hysterectomy, which can protect ureters, uterine artery and other adjacent structures during the approach.

关 键 词：经阴道广泛性子宫切除 膀胱宫颈韧带 主韧带 骶子宫韧带 应用解剖 

分 类 号：R713[医药卫生—妇产科学]