子宫颈支持韧带内自主神经走行研究

目的研究子宫颈周围支持韧带内自主神经的走行。方法分别切取3具成年女性尸体双侧的主韧带、宫骶韧带和膀胱宫颈韧带，用通用的神经标记物（S100）对各韧带不同部位切缘的神经分布做免疫组化定位分析。结果主韧带平均长度为5．0cm，距子宫颈4．5cm处，神经主要分布于韧带的中部；距子宫颈3．0cm和2．0cm处，神经主要位于韧带的中下部，并靠近腹侧；距子宫颈0．5cm处，神经走行于韧带的尾侧腹侧面。宫骶韧带平均长度为6．5cm，距子宫颈6．0cm处，神经主要分布于韧带头侧内侧面；距子宫颈4．5cm、3．0cm和1．5cm处，神经主要位于韧带的中部和下部，并靠近外侧；距子宫颈0．5cm处，神经走行于韧带的尾侧外侧面。膀胱宫颈韧带平均长度为2．3cm，在距子宫颈2．0cm、1.5cm、1．0cm和0．5cm处，神经均主要分布于膀胱宫颈韧带深层的膀胱静脉内侧。结论主韧带内神经在盆腔壁侧由从韧带的中部起始向内向下向前走行至子宫颈；宫骶韧带内神经由盆腔壁起始向前向外向下走行至子宫颈；膀胱宫颈韧带内神经主要分布于韧带深层的膀胱静脉内侧。

Objective To study the trend of autonomic nervous in supporting ligaments of cervix uteri. Methods Two sides of cardinal ligaments, uterosaeral ligaments and vesicouterine ligaments from three fixed adult female cadavers were collected. Immunohistochemical analysis of surgical margins was performed to study the distribution of autonomic nerves using a general nerve marker（S100） within sections of biopsies. Results （1）The mean length of cardinal ligaments was 5.0cm, nervous located in the middle part of the ligaments at a distance of 4.5cm from cervix uteri ,in the middle and inferior part of the ligaments and closed to the ventral side at 3.0cm and 2.0cm, in the caudal and ventral side of the ligaments at 0. 5cm. （2）The mean length of uterosacral ligaments was 6. 5cm,nervous located in the medial and top part of the ligaments at a distance of 6. 0cm from cervix uteri, in the middle and inferior part of the ligaments and closed to the lateral side at 4. 5cm,3.0cm and 1.5cm,in the caudal and lateral side of the ligaments at 0. 5cm. （3）The mean length of vesicouterine ligaments was 2.3cm, nerves located in the medial side of the vesical veins in deep layer of the vesicouterine ligaments at a distance of 2. 0cm, 1.5cm, 1.0cm and 0. 5cm from cervix uteri. Conclusion Nerves starts in the middle part of cardinal ligaments and goes medially, downward and forward from pelvic wall to cervix uteri, goes forward, laterally and downward from pelvic wall to cervix uteri in uterosacral ligaments and locates in the medial side of the vesical veins in deep layer of the vesicouterine ligaments.