盆腔筋膜的胚胎学研究进展

Research progress on topography of the pelvic fasciae

目的探讨盆腔筋膜胚胎发育过程，提高对盆腔筋膜结构层次的认识，为直肠癌的外科治疗和影像学诊断提供理论支持。方法以“胚胎学”“盆腔筋膜”“直肠系膜”为关键词在万方数据、PubMed数据库查阅1908年6月—2015年6月发表的与直肠筋膜胚胎学研究相关文献，进行汇总分析。结果盆腔筋膜的胚胎学发育经过间充质期、结缔组织形成期和脂肪组织形成期3个时期逐渐形成完整的环形筋膜结构，以直肠固有筋膜包绕的直肠与直肠系膜构成内层，以盆腔壁层筋膜及前方的Denonvilliers筋膜构成外层，与成人解剖研究中的环形筋膜结构相符。结论盆腔筋膜的胚胎学研究进一步证实了盆腔筋膜的环形分布理论，为直肠癌影像学诊断及外科治疗提供了理论支持。

Objective To provide theoretical support for the correct understanding of pelvic fascia structure and surgical treatment and diagnosis for rectal cancer. Methods To search foreign references in recent years from June 1908 to June 2015, with the key words of ＂embryology＂, ＂pelvic fasciae＂ and ＂mesorectum＂, which are related to topography of the pelvic fasciae at Pubmed and Ovid Medline database. Results The development of the pelvic fasciae can be divided into three periods： mesenchymal period fibrous period and adipose period. After this, fasciae can be identified as a complete circle structure, the fascia propria form the inner layer, the pelvic parietal fascia and Denonvilliers＇ fascia form the outer layer, similar to the circle structure in human. Conclusions The embryology of pelvic fascia study confirmed the circular distribution of pelvic fascia, provides a theoretical support for surgical treatment and diagnosis for rectal cancer.