闭孔淋巴结清扫术的应用解剖  

Applied anatomy of dissecting the obturator lymph nodes

作　　者：王海杰[1] 王枚博[2] 李奇[1] 解家英[3] 

机构地区：[1]复旦大学医学院解剖学教研室,上海200032 [2]复旦大学药学院,上海200032 [3]潍坊市人民医院妇产科,山东潍坊261041

出　　处：《中国临床解剖学杂志》2002年第6期441-443,共3页Chinese Journal of Clinical Anatomy

基　　金：教育部留学回国人员科研启动基金资助项目 ( 97832 );山东省教委科技计划项目 (J98K6 0 )

摘　　要：目的 :探讨淋巴结染色在闭孔淋巴结清扫术中的作用。方法 :在 56例 (1 1 2侧 )成人尸体标本 ,观察闭孔淋巴结的形态、分布及其与闭孔血管神经等结构的毗邻关系。将 2 0例宫颈癌病人分为淋巴结染色组和对照组。在淋巴结染色组 ,子宫颈注射 0 .3 %叶绿素 ,显示闭孔淋巴结。结果 :闭孔淋巴结 1～ 3个 ,体积较小 ,主要分布于闭孔血管神经的上段周围和闭膜管内口处。在 87侧标本 (78% ) ,闭孔血管神经的排列关系自前而后为神经、动脉、静脉。出现异常闭孔动脉 (1 3 % )、异常闭孔静脉 (4% )和闭孔疝(61 % )。在宫颈癌病人 ,淋巴结染色组切除闭孔淋巴结的数目比对照组多。结论 :闭孔淋巴结体积较小 ,位置较深 ,且与闭孔血管神经毗邻密切。Objective: To study the effect of lymphatic coloration on dissecting the obturator nodes. Methods: The shape and distribution of the obturator nodes and the relation between the nodes and surrounding stuctures were observed on 56 adult cadaveric specimens. Twenty patients with cervical carcinoma were divided into lymphatic coloration group and control group.In the lymphatic coloration group, 0.3% chlorophyllin was injected into the cervix to make the obtruator nodes visible. Results: The obturator nodes were small, varing from 1 to 3 in number.The nodes spreaded along the upper part of the obturator vessels and nerves and located at the inner aperture of the obturator canal.In 87 sides (78%) of the pelvis, the obturator nerve was in the front of the obturator artery and the obturator vein. There were abnormal obturator arteries (13%), abnormal obturator veins (4%) and obturator hernias (61%). In the patients with cervical carcinoma, the number of the dissected obturator nodes in the lymphatic coloration group was greater than that in the control group. Conclusion: The obturator nodes are difficult to be observed because the nodes are small and in the obturator fossa. Administration of chlorophyllin through cervical injection facilitates a more complete excision of the obturator nodes.

关 键 词：应用解剖 闭孔淋巴结 淋巴结清扫术 叶绿素 宫颈癌 闭孔神经 

分 类 号：R322.27[医药卫生—人体解剖和组织胚胎学] R737[医药卫生—基础医学]