人舌淋巴管分布及引流特征的研究

Study on Distribution and Drainage of Lymphatic Vessels of Tongue

目的了解舌淋巴管的分布及引流特征,以期为舌部肿瘤的治疗提供可靠的解剖学依据。方法应用淋巴管间接注射技术结合淋巴管铺片透明显示法、淋巴管铸型及扫描电镜观察来研究人舌淋巴管的分布特点,同时通过颈部解剖学方法观察舌不同区域初级引流淋巴结的分布。结果舌背黏膜毛细淋巴管和淋巴管构成双层网络结构,其分布不受界沟和中线的影响,分布于整个舌背黏膜。肌间淋巴管与舌背和舌腹黏膜淋巴管相交通,由此构成完整的舌淋巴管网络结构。各注射区域颈部初级引流淋巴结的分布呈现一定的特点,舌前部主要引流至颏下淋巴结、颌下淋巴结和颈肩胛舌骨肌淋巴结;舌侧部和舌中部主要引流至颌下淋巴结、颈二腹肌淋巴结和甲状淋巴结;舌根部主要引流至颈二腹肌淋巴结。各注射区初级引流淋巴结均可出现于双侧颈部,但同侧发生频率高于对侧。结论舌淋巴管呈网络状分布,舌部任一区域的淋巴引流有广泛性和双侧性的特点,同时又具有一定的趋向性。

Objective To investigate the distribution and drainage of lymphatic vessels of tongue, and to provide anatomical evidence for treatment of tongue cancer. Methods Indirect lymphatic injection was employed, combined with clearing method with winter green oil and corrosive east technique, to study the distribution of lymphatic vessels of tongue. Anatomical methods were used to detect the sentinel lymph nodes in different region of tongue. Results The lymphatic vessels of dorsal mueosa composed of lymphoeapillary vessels and anstomosing side branches were present by superficial and deep capillary networks. The distribution of lymphatic networks extend from tip to base and from one board to another, and was not influenced by the suleus terminalis and median hngual suleus. Lymphatic vessels in the muscular portion communicated with lymphocapillary network of dorsal and ventral mueosa, which made the lymphatic vessels of tongue to be an integrity network structure. These characters of distribution influenced the lymphatic drainage of tongue. The results showed principal sentinel lymph nodes （SLNs） for anterior part of tongue were submental lymph nodes, submandibular lymph nodes and juguloomehyoid lymph nodes, for lateral part and middle part of tongue were submandibular lymph nodes, juguledigastfie lymph nodes and thyroid lymph nodes, and for root part of tongue were juguledigastrie lymph nodes. SLNs for every injection region were all presented at bilatral neck, but the frequency of stained SLNs at homelateral neck was more than that at contralateral neck. Conclusion The lymphatic vessels of tongue arranged like a network, which made the lymphatic drainage at various ways and made the distribution of sentinel lymph nodes to be bilateral and dispersive.