女性输尿管盆腔段的应用解剖学研究

Study on the Applied Anatomy of Ureter Pelvic Walk

目的:通过观测女性输尿管盆腔走行,为妇科腹腔镜手术中保护输尿管提供解剖学依据。方法:解剖15例(30侧)国人成年女性尸体输尿管,观察每具尸体输尿管的盆腔走行情况,并对输尿管与卵巢动脉末端的垂直距离、与宫骶韧带子宫端的垂直距离以及与子宫动脉交叉处至子宫的垂直距离进行观测。结果:输尿管至卵巢动脉末端的平均垂直距离:左(1.89±0.43)cm,右(1.58±0.32)cm;输尿管至宫骶韧带子宫端的平均垂直距离:左(2.53±0.57)cm,右(2.51±0.76)cm;输尿管与子宫交叉处至子宫的平均垂直距离:左(1.83±0.30))cm,右(2.04±0.54)cm。结论:在妇科腹腔镜手术中,处理右侧骨盆漏斗韧带需要更加注意保护右侧输尿管;结扎左侧子宫动脉需要更加注意保护左侧输尿管;处理宫骶韧带子宫端,两侧不需要区别对待。

Objective:To observe and measure ureter pelvic walk in order to provide an anatomical information for protecting ureter in gynecologic laparoscopies.Methods:15 adult females(30 ureters)were dissected.The ureter pelvic walk of ureters were observed.The vertical existence of ureters between end of the ovarian artery and uterine extremity of uterosacral ligament were measured and analyzed.In addition,the vertical existence of the ureter and the uterus artery’s intersection between uterus were measured and analyzed.Results:Average vertical existence of the ureter between end of the ovarian artery was(1.89±0.43)cm in left and(1.58±0.32)cm in right.Average vertical existence of the ureter between uterine extremity of the uterosacral ligament was(2.53±0.57)cm in left and(2.51±0.76)cm in right.Average vertical existence of the ureter and the uterus artery’s intersection between uterus was(1.83±0.30)cm in left and(2.04±0.54)cm in right.Conclusion:In gynecological laparoscopic surgery,more attention should be paid to protect the right ureter when dealing with the right pelvic funnel ligament.And the left uterine artery needs to be more carefully handled to protect the left ureter.But when it comes to the treatment of the uterine end of the sacral ligament,the two sides do not need to be treated differently.