人肛门外括约肌与臀大肌的形态计量学对比研究

COMPARATIVE STUDY OF EXTERNAL ANAL SPHINCTER AND GLUTEUS WITH MOPHOMETRY

目的从形态学方面分析直肠癌Ｍｉｌｅｓ术后用臀大肌重建肛门外扩约肌的合理性。②方法取６例直肠癌病人行Ｍｉｌｅｓ术后的肛门外扩约肌和一侧臀大肌组织，用形态计量学方法比较两部位肌细胞光镜和超微结构差异。③结果肛门外括约肌和臀大肌组织中的肌细胞核的体密度、面密度、数密度差异无显著性（ｔ＝１．１０７～１．４６５，Ｐ＞０．０５）。两组织中Ⅰ，Ⅱ型细胞间线粒体的体密度、面密度差异无显著性（ｔ＝０．０７３～０．４４２，Ｐ＞０．０５）；两组织中Ⅰ，Ⅱ型肌细胞间的Ｚ线和Ｍ线宽度差异无显著性（ｔ＝０．０６２～１．２６１，Ｐ＞０．０５）；两组织中Ⅰ，Ⅱ型肌细胞间同样参数差异无显著性（ｔ＝０．３６６～１．２６１，Ｐ＞０．０５）。两组织中Ⅰ，Ⅱ型肌细胞的肌原纤维含量差异无显著意义（ｔ＝１．４６８，１．９６４，Ｐ＞０．０５）。

Objective External anal sphincter(EAS) and gluteus were compared by morphometry in order to provide data for reconstruction of external anal sphincter with gluteus after Miles operation. Methods Skeletal muscle samples from EAS and gluteus were taken from six patients with rectum cancer after Miles' operation. Histological and ultrastructural differences of muscle cells between two samples were compared by morphometry. Results There were no significant differences in relative volume, relative surface area, relative number occupied by nuclei between EAS and gluteus(t=1.107—1.465, P>0.05); Comparison between EAS type Ⅰ,Ⅱ fibers and gluteus type Ⅰ,Ⅱ fibers showed no differences in the relative volume or relative surface area occupied by mitochondria(t=0.073—0.442, P>0.05); The width of Zdisc and Mline in type Ⅰ and type Ⅱ fibers between EAS and gluteus had no significant differences(t=0.062—1.261, P>0.05); The myofibril density in type Ⅰ,Ⅱ fibers between EAS and gluteus had no differences(t=1.468—1.964, P>0.05). Conclusion The results of the study showed that it is possible to reconstruct EAS by gluteus after Miles's operation. 