人体积水输卵管形态结构研究

Morphological structures of human hydrosalpinx

【目的】本实验通过腹腔镜、输卵管镜、扫描电镜从大体到微观全面观察输卵管的解剖结构,并比较正常伞与积水远端输卵管黏膜上皮的超微结构差异。【方法】实验组:选取45例因输卵管积水、远端闭锁、需要伞端整形的不孕症患者,取其远端闭锁部位中心,约3 mm×3 mm的小块组织;对照组:选取25例因子宫全切除的、输卵管无积水的患者,在远端取同等大小的组织块;两组均在扫描电镜下观察并测量相关数据。腹腔镜及宫腔镜下观察输卵管,并录像拍片。【结果】实验组纤毛细胞数、分泌细胞数分别与对照组比较差异有统计学意义(P<0.05)。实验组纤毛长度、纤毛直径、单个分泌细胞及纤毛细胞的大小分别与对照组比较差异无统计学意义(P>0.05)。【结论】积水破坏输卵管的大体解剖形态及管腔内的黏膜皱襞,使得输卵管输送功能减弱或丧失。积水输卵管的纤毛长度与直径没有明显变化,但是纤毛细胞数目明显减少且每个纤毛细胞上的纤毛数量减少,分泌细胞数目明显增加,这就是积水输卵管上皮的主要超微结构变化。结果提示,分泌细胞的明显增多,也许就是引起输卵管积水的主要原因。

【Objective】To generally observe the anatomical structures of Fallopian tubes from general level to microcosmic level via laparoscopy, hysteroscopy and scanning electron microscopy, and compare the ultrastructures of mucosal epithelia between the normal fimbria of a fallopian tube and distal end of hydrosalpinx.【Methods】In the experimental group, 45 infertile women with hydrosalpinx and distal occlusion who needed fimbriae shaping were selected. Tissues about 3 mm × 3 mm were taken from the centers of distally blocked sites. In the control group, 25 women without hydrosalpinx who had received hysterectomy were enrolled. Tissues in the same size were taken from the same sites. The tissues in both groups were observed under scanning electron microscope, and related data were measured.The fallopian tubes were observed via laparoscopy and hysteroscopy. Photos and videos were then taken.【Results】The numbers of ciliated cells and secretory cells in the control group were significantly different those in the experimental group（P〈0.05）. However, there was no significant difference in the ciliary length and diameter, as well as the size of ciliated cells and secretary cells between the two groups（P〉0.05）.【Conclusion】Hydrosalpinx destroys the general anatomic structures of Fallopian tubes and intraluminal mucosal folds.Then the transportation function of Fallopian tubes is weakened or even lost. Although hydrosalpinx does not have an obvious influence on the ciliary length and diameter, it does lead to obviously-reduced ciliated cell number and cilium number on each ciliated cell, and obviously-increased secretory cell number. The obviously-increased number of secretory cells might be the major cause for hydrosalpinx.