人膀胱肌内神经分布及其意义

Significance and distribution of intramuscular nerve in human bladder

目的探讨人完整膀胱肌内神经分支分布。方法采用Sihler's肌内神经染色、HE染色法研究人膀胱12个。结果人膀胱似三棱锥形,肌纤维呈编织状排列,膀胱底两侧可见多支较粗大的神经干与膀胱下动脉伴行,成簇状于输尿管膀胱连接部进入膀胱壁,在膀胱壁内不同层面分出初级与次级神经支,相邻的神经支间有交叉支配,神经纤维沿膀胱长轴向内延伸呈树枝样分布,左右两侧神经纤维在中线交叉甚少,右侧神经支明显多于左侧,有神经纤维到输尿管下段。结论人膀胱肌内神经分布可以用Sihler's染色法研究;支配人膀胱的神经在膀胱输尿管连接部成簇进入,在膀胱壁内交织成网状,具右侧优势分布;有分支支配输尿管下段。

【Objective】To investigate the distribution of intramuscular nerve of intact bladder in human.【Method】 12 bladders were obtained legally which adopted with Silher＇s technique and HE technique.【Results】Triangu-larpyramid-shaped bladder,with it＇s muscular fibers knit closely.Some big and thick bladder nerve bunches accompanied with inferior bladder artery on both sides of the bladder bottom,form the nerve clusters near the ureterovesical junction into the bladder wall,then give off the primary and the secondary branches on different layers of bladder muscle.The nerve branches cross-dominated and extend inward and with distribution of tree-like along the long axis of bladder,have few crossover near the midline while nerve branches dominate mainly on the left side.Lower ureter also gains the innervation of intramuscular nerve【.Conclusion】Sihler＇s stained technique can be used for the exploration of bladder intramuscular nerve,which merge into the clusters near the ureterovesical junction into bladder muscle.The nerve fibers weave into mesh and distribute mainly on the left wall of bladder,several branches distribute to the lower ureter.