输精管行程的解剖学测定及其在临床上的应用

Routing Reseach of Vas Deferens on Anatomy And Clinical Application

目的:为输精管外科、尤其长段输精管缺损再吻合提供解剖学基础。方法:观察18具成人尸体的输精管行程,测量输精管各段的长度及输精管末端至皮下环的距离。结果:输精管从皮下环经腹环到壶腹,行程中绕了个大弯。使输精管直接从外环穿出,消除该弯曲,可缩短输精管6.1～12.9(9.31±1.30)cm。输精管各段的长度分别为:睾丸段3.2～5.6(4.53±0.79)cm,精索段4.5～9.5(7.31±1.78)cm,腹股沟段4.4～7.5(5.52±0.74)cm,盆段12.5～19.5(16.75±1.87)cm,壶腹段2.9～3.8(3.63±0.23)cm。输精管长度、各段长度、两侧对比无显著差异性。结论:①游离输精管使之不经腹环和腹股沟管而直接从皮下环穿出可缩短输精管行程6.1～12.9 (9.31±1.30)cm,这是长段输精管缺损,缩短行程手术学再通的解剖学基础。②两侧输精管各段及总长度差异无显著性。③输精管的外科手术与各段位置密切相关。

Objective:To study the routes of vas deferens in order to provide anatomy basis for surgical operation,especially,in reconstructing of long scgment loss of vas deferens.Methods:The routes of vas deferens were observed and anatomic distances along epididymal,infrainguinal,inguinal,retroperitoneal and ampullar seg- ments of vas deferens,the distances from external ring to extremity of vas deferens were measured respectively in 18 formalin fixed adult cadavers.Results:The vas deferens have a large curve from external ring to extremity in this routs,draw it out from the external ring.Eliminating this curve will allow to shorten this segm ent of vas def- erens for vasovasotomy by 6.1～12.9(9.31±1.30)cm.The length of each segment of vas deferens,respecuvely,is e- pididymal;3.2～3.6(4.53±0.79)cm,infrainguinal:4.5～9.5(7.31±1.78)cm,mguinal:4.4～7.5(5.52±0.74)cm,retnoperi- toneal:12.5～19.5(16.75±1.87)cm and ampullar:2.9～3.8(3.63±0.23)cm.There was no significant differences in seg- ment length and the distances from external ring to extremity of vas deferens between the right and left.Conclu- sion:Recontruction of long segment loss of vas deferens can be performed by mobilization retroperitoneal vas deferens and draw it out from external ring.There were no significant differences in lengths of vas deferens and the distances from external ring to vassal extremity between the left and right in adults.The surgical operations of vas deferens are closely related with site of each segment of vasa.