改良的Sihler's染色法显示成人输尿管和回肠壁内神经分布  

Modified Sihler's staining showed nerve distribution in the ureter and ileum wall in adults

作　　者：吴宇波 伍骏锋 WU Yu-Bo;WU Jun-Feng(Department of Urology,Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital,Kaili,Guizhou Province 556000,China)

机构地区：[1]黔东南苗族侗族自治州人民医院泌尿外科,贵州凯里556000

出　　处：《解剖学研究》2024年第2期145-154,共10页Anatomy Research

基　　金：黔东南州科技计划(自筹资金)项目(黔东南科合J字[2023]125号)。

摘　　要：目的探讨改良的Sihler’s染色法显示成人输尿管和回肠壁内神经分布的应用。方法选取教学解剖尸体中输尿管和回肠6具,最终获得12条输尿管和6段回肠进行改良的Sihler’s染色法整体染色,于X线阅片灯下、组织压片、免疫组化观察输尿管和回肠壁内神经分支、分布、走形总结两者肌内神经分支、分布规律及形态学特征。结果大体解剖很难辨认输尿管的神经来源,可见回肠系膜内一些纤细的白色神经支进入肠壁。Sihler’s染色后,见输尿管和回肠呈透明胶冻状,壁内神经支呈深蓝色,浆膜面更为清晰。输尿管外膜层内的神经与血管伴行,近似垂直进入管壁,逐渐向肌层延伸并沿纵轴分布;整体见管壁上、中段神经稀少,分支逐渐变细,相邻分支间交叉较少;输尿管下段神经较为密集,见经膀胱输尿管连接部成簇状进入输尿管下段向近端延伸的粗大神经支,分布密集,向上逐渐分出初级及次级神经支,相邻神经间有分支交错及伴行,每根神经的分支不在一个平面上固定,可观察视野内未发现神经节。回肠外形完整,浆膜层神经分支呈现深蓝色,与动脉伴行,并向肠壁分出初级及次级神经支,部分直接跨越血管网分布至肠系膜侧壁,到达肠壁的壁内神经环形、垂直分布于肠管壁,呈树枝状。相邻的神经分支相互交叉,每根神经束的分支不在一个平面上固定,可观察视野范围内未见明确神经节。Sihler’s染色透明的输尿管、回肠切取组织压片:见两者神经纤维均由外向内至黏膜层分布,输尿管壁内沿纵轴走向,肠壁呈近似垂直向对系膜侧走向,呈网状分布,分支逐渐变细,神经纤维间明显交叉,均未见明确神经节样结构。免疫组化见输尿管肌内神经纤维呈束状、纵行分布,交叉较少;回肠壁内肌间有神经纤维网格状分布,肌间见有大量的神经节结构。结论成人输尿管和回肠壁内神经能被染�Objective To investigate the application of modified Sihler's staining to show the distribution of nerves in the ureter and ileum wall in adults.Methods 3 ureters and ileum were selected from teaching autopsy ca-davers,and 6 ureters and 3 segments of ileum were obtained for overall staining by modified Sihler's staining method.The nerve branches,distribution and shape in the ureter and ileum wall were observed under X-ray reading lamp,tissue compression and immunohistochemistry,and the intramuscular nerve branches,distribution and morphological characteristics of both were summarized.Results It is difficult to identify the nerve source of the ureter on gross anatomy.Some fine white nerve branches in the ileocenteric mesentery can be seen entering the intestinal wall.After Sihler's staining,the ureter and ileum were hyaline jelly,the intramural nerve branches were dark blue,and the serous surface was more distinct.The nerves and blood vessels in the ureteral outer layer accompany,enter the tube wall approximately vertically,and gradually extend to the muscular layer and distribute along the longitudi-nal axis.As a whole,there were few nerves in the upper and middle parts of the tube wall,and the branches gradual-ly became thinner.The nerves in the lower segment of the ureter are relatively dense,and the thick nerve branches extending proximal to the lower segment of the ureter are clustered through the vesicoureteral junction,with dense distribution.The primary and secondary nerve branches gradually diverge upward,and there are staggered and con-current branches between adjacent nerves.The branches of each nerve are not fixed on the same plane,and no gan-glia can be found in the visual field.The ileum is complete in appearance,with dark blue nerve branches in the serous layer,which accompany the arteries,and branch out into primary and secondary nerve branches towards the intestinal wall.Some of them are distributed directly across the vascular network to the lateral wall of the mesentery,and the intramural nerves

关 键 词：输尿管 回肠 肌内神经 Sihler’s染色法 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]