研究输尿管平滑肌的纤维构筑及探讨输尿管结石下降困难的机理与对策  

Study on the fiber architecture of the ureteral smooth muscle and the mechanism and countermeasure of the difficulty in descending ureteral calculi

作　　者：李丽娟 张文静 张晓伟 刘宇琨 刘涛红 刘学钧 Li Lijuan;Zhang Wenjing;Zhang Xiaowei;Liu Yukun;Liu Taohong;Liu Xuejun(Department of Anatomy,Huaxin College of Hebei Geo University Shijiazhang 050000,China;Hospital of Stomatology,Hebei Medical University,Shijiazhang 050000,China;School of Basic Medicine,North China University of Technology,Tangshan 063000,China)

机构地区：[1]河北地质大学华信学院解剖教研室,石家庄050000 [2]河北医科大学口腔医院,石家庄050000 [3]华北理工大学基础医学院解剖教研室,河北唐山063000

出　　处：《中国临床解剖学杂志》2024年第4期429-434,共6页Chinese Journal of Clinical Anatomy

基　　金：河北省卫生健康委医学科学研究课题计划项目(20231104)。

摘　　要：目的研究输尿管各段平滑肌纤维构筑及分布规律,为治疗输尿管结石提供形态学依据。方法30例新鲜成人输尿管经福尔马林固定,组织切片,在光学显微镜下观察输尿管各部平滑肌的形态及其分布规律,用测微计测量输尿管平滑肌的厚度和内径,并显微照相。结果输尿管起始部的平滑肌分4层,以环行肌为主,平滑肌最大厚度左侧1.59 mm,右侧1.51 mm;内径左侧最宽2.22 mm,右侧2.05 mm。腹段平滑肌较厚分3层,以环形肌为主,左侧最大厚度1.49 mm,右侧1.69 mm。小骨盆入口段输尿管处的平滑肌分为3层,其中大多为纵行肌。其左侧平滑肌最大厚度为2.38 mm,右侧为1.98 mm;输尿管内径左侧为2.11 mm,右侧为2.28 mm。盆段的输尿管有4层平滑肌,大多为纵行肌和环形肌,平滑肌最大厚度左侧1.69 mm,右侧1.58 mm。壁内段的平滑肌分3层,平滑肌最厚,左侧最大厚度3.18 mm,右侧3.21 mm,纵行肌最为发达,环形肌和尿道括约肌相联系。输尿管内径,左侧1.25 mm,右侧1.70 mm,本文讨论了输尿管平滑肌构筑与尿动力学的相互关系。结论输尿管结石崁顿下降困难主要原因可能与输尿管平滑肌的纵行肌和环形肌配布有关。Objective To study the fiber architecture and distribution of smooth muscle in each segment of the ureter and provide morphological basis for the treatment of ureteral stones.Methods Thirty fresh adult ureters were fixed by formalin with tissue sections to observe the morphology and distribution pattern of smooth muscle of the ureter under optical microscope The thickness and inner diameter of ureter smooth muscle by micrometer were measured.Results The smooth muscle at the beginning of the ureter was divided into four layers,and the maximum thickness of the smooth muscle was 1.59 mm on the left and 1.51 mm on the right.The maximum diameter on the left was 2.22 mm and 2.05 mm on the right.The abdominal smooth muscle was divided into three layers,and the left maximum thickness was 1.49 mm and 1.69 mm on the right.The smooth muscle in the ureter at the entrance of the small pelvis was divided into three layers,most of which were longitudinal muscle,the maximum thickness of smooth muscle on the left side was 2.38 mm,1.98 mm on the right side.The inner diameter of the ureter was 2.11 mm on the left and 2.28 mm on the right.The ureter in the pelvic segment has four layers of smooth muscle,mostly longitudinal muscle and annular muscle,the maximum thickness of smooth muscle was 1.69 mm on the left and 1.58mm on the right.The smooth muscle of the inner wall segment was divided into three layers,the smooth muscle was the thickest,the maximum thickness on the left was 3.18mm and 3.21 mm on the right.The longitudinal muscle was the most developed,and the annular muscle was associated with the urethral sphincter.The ureteral inner diameter was 1.25 mm on the left and 1.70 mm on the right.The interrelationship between ureteral smooth muscle construction and urodynamics was discussed.Conclusions The main reason for the difficulty in the reduction of ureteral calculi may be related to the arrangement of longitudinal muscle and circular muscle of ureteral smooth muscle.

关 键 词：输尿管 平滑肌构筑 尿动力学 输尿管结石 

分 类 号：R322.63[医药卫生—人体解剖和组织胚胎学]