科学解读膜解剖理论 规范应用膜解剖名词  

Scientific interpretation of membrane anatomy theory and standardized application of membrane anatomy terms

作　　者：刘海龙 常毅 林谋斌[1] Liu Hailong;Chang Yi;Lin Moubin(Department of General Surgery,Yangpu Hospital,Institute of Gastrointestinal Surgery and Translational Medicine,Tongji University School of Medicine,Shanghai 200090,China)

机构地区：[1]同济大学附属杨浦医院普通外科,同济大学医学院胃肠外科和转化医学研究所,上海200090

出　　处：《中华胃肠外科杂志》2020年第7期634-642,共9页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金面上项目(81874201)。

摘　　要：膜解剖虽然在国内兴起,但现在还只是初步建立了理论框架。膜解剖的"膜"实际是指构成特定平面或称为"神圣平面"的"膜",因此不能把"膜"之间的解剖就理解为膜解剖,膜解剖的目的也绝非是为了追求"微出血"和"零出血"。现阶段理论学说的多样化以及解剖名词的不规范,是阻碍膜解剖理论进一步发展的"瓶颈"。膜解剖的膜或层面始于胚胎期,但因为发育过程中出现的旋转、融合等而失去了原来的解剖表现,从而模糊了临床对膜解剖的认识。笔者结合尸体解剖、手术观察和文献复习,还原了结直肠手术相关膜的来源和延续,并以全直肠系膜切除术为例,对"系膜信封"以及完整系膜切除等膜解剖核心内容进行了探讨。同时,从膜的整体性上阐释了重要术语的解剖学定义,以期规范膜解剖名词的使用。从胚胎学、膜的整体性和延续性来理解膜的来源和构成,将有助于建立统一规范的膜解剖理论体系。There has been an upsurge of the theory of membrane anatomy in China,but it is still in the initial stage of establishing preliminary framework.The concept of fasciae in membrane anatomy actually refers to the fasciae constituting the particular plane or the'holy plane’.Therefore,the membrane anatomy can't simply be defined as the anatomical relationship among fascia.The application of the membrane anatomy is also not just to pursue the avascular plane in the surgical field.Nowadays,nonstandard anatomical terms and diversification of views impede the development of the theory of the membrane anatomy.Fasciae occur in embryonic stage,undergo a series of changes in rotation and fusion,and lose the original features,which bring difficulties in understanding the anatomy of fasciae.In this paper,we restore the origin and continuity of fasciae related to the colorectal surgery by cadaveric study,surgical observation and literature review.Taking the TME for example,we also discuss the core content about the fasciae and plane related to'mesenteric envelope’and complete mesorectal excision.From the perspective of the fasciae integrity,we illustrate the definitions of important anatomical structure and standardized the terminology of fasciae.To study the origin and architecture of fasciae in the view of embryology,integrity and continuity will contribute to establish the standard theoretical system of membrane anatomy.

关 键 词：解剖 术语 系膜 筋膜 盆腔 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]