汉族人眶脂肪之间相通性的断层解剖学研究

A sectional anatomical study on the interconnection of orbital fat in the Han nationality

目的研究汉族人眶脂肪的分布及相互之间的交通情况,为眼眶部手术提供解剖学依据。方法选用12对以甲醛固定的眼眶标本及5对新鲜的眼眶标本。将12对固定的眼眶标本去除眶壁,保留完整的骨膜,取出眶组织,以3 mm厚度分别制成冠状位、矢状位和水平位的断层标本。其中各取2对断层标本制成组织切片,分别进行HE和Masson染色,并对断层标本和组织切片进行观察。分别向5对新鲜标本的上下睑内注射亚甲蓝和曙光红A染料,制成断层进行观察。结果在断层解剖和组织切片中发现眶隔脂肪之间有隔膜存在,将其分隔成大小不同的脂肪团,眶隔脂肪沿肌肉和骨膜之间的通道向后延续。眼外肌周围存在筋膜组织,其与骨膜和脂肪小叶之间有广泛的纤维连接,并不能形成完整的隔膜。肌肉内外的眶脂肪通过眼外肌间隙相互延续。在染料注射研究中发现,注入上睑和下睑的染料都可以向眶后部脂肪中渗透,且能渗入肌肉内的眶脂肪。结论眶脂肪自前向后是一个延续的整体,周围性眶脂肪是通过眼外肌间隙与中央性眶脂肪相互延续。肌肉周围的筋膜组织和眶脂肪维持着肌肉和眼球的位置。

Objective To obtain an anatomical basis for orbital operation through the study of the distribution and interconnection of orbital fat. Methods Twelve pairs of formalin-fixed orbital specimens and 5 pairs of fresh orbital specimens were selected. The fixed orbital specimens were removed from the orbital wall, but retained the intact periosteum. Then the specimens were fitted for the coronal,sagittal, and horizontal level by 3 mm thickness. Each pair of sectional specimens were made of histologic section, then HE and Masson staining were performed, respectively. The sectional specimens and tissue sections were observed. The fresh specimens were injected with methylene blue and dawn red A dye through the upper and lower eyelid, and sections were made for observation. Results In the sectional specimens and tissue sections, a thickened diaphragm was found between the orbital septum fat, which is divided into different sizes of cellulite, and the orbital fat continues along the channel between the muscle and the periosteum. Although there is fascia around the muscles,and it has a wide range of fiber connections with periosteum and fat leaflets, it cannot form a complete diaphragm. As a result, the intramuscular and extramuscular orbital fat interconnect with each other. In the dye injection experiment, dyes injected into the upper and lower eyelids were able to penetrate the fat in the posterior orbit and enter the orbital fat in the muscle. Conclusion Orbital fat is a continuation of the whole from the front to the back. Peripheral orbital fat continued with central orbital fat through the gap between the four rectal muscles. The fascia around the muscle and the orbital fat maintains the position of the muscle and eye.