宫颈周围支持韧带内交感神经分布的研究.doc

宫颈周围支持韧带内交感神经分布的研究 郭东霞,陆　忆,冯兰兰,张建平* 　　(苏州大学附属第一医院妇产科,苏州　215006) 　　【摘要】　目的:观察交感神经在宫颈支持韧带内的分布。方法:用特异性交感神经标记物酪氨酸羟化酶(tyrosine hydroxylase,TH)抗体对主韧带、宫骶韧带及膀胱宫颈韧带不同位置的切片进行免疫组化染色,观察这些韧带内TH阳性纤维的分布。结果:主韧带平均长度5. 0cm,距宫颈4. 5cm、4. 0cm、3. 5cm、3. 0cm、2. 5cm、2. 0cm处未见TH阳性纤维,距宫颈1. 5cm处TH阳性纤维位于韧带中部,距宫颈1. 0cm、0. 5cm处TH阳性纤维分布在韧带尾侧。宫骶韧带平均长度6. 5cm,距宫颈6. 0cm、5. 5cm处TH阳性纤维位于韧带头侧的内侧面;距宫颈5. 0cm、4. 5cm、4. 0cm、3. 5cm、3. 0cm、2. 5cm、2. 0cm处,TH阳性纤维集中在韧带中下部的外侧面;距宫颈1. 5cm、1. 0cm、0. 5cm处,TH阳性纤维位于韧带尾侧的外侧面。膀胱宫颈韧带平均长2. 3cm,距宫颈2. 0cm、1. 5cm、1. 0cm、0. 5cm处TH阳性纤维均位于膀胱宫颈韧带深层,散在分布于膀胱静脉内侧。结论:主韧带内交感神经分布在韧带宫颈侧的中下部;宫骶韧带内交感神经自盆壁侧韧带的头侧内侧面向前、向下、向外走行至宫颈;膀胱宫颈韧带内交感神经在韧带深层由宫颈前外侧至膀胱底壁均走行在膀胱静脉内侧。 　　【关键词】　宫颈;交感神经纤维;支持韧带;免疫组织化学;酪氨酸羟化酶 　　【Abstract】　Objective:To observe the distribution of sympathetic fibers in supportingligaments around the cervix uter.iM ethods:Immunohistochemical analysis ofdifferentpositionsofparaffin sections of cardinal ligaments, uterosacral ligaments and vesicouterine ligaments sur-gicalmarginswas performed to observe the distribution of sympathetic fibers by using an anti-body against tyrosine hydroxylase(TH), a specific marker of sympathetic fibers.Results:(1)Themean length of cardinal ligamentswas 5. 0cm, there were no TH-positive fibers located inthe ligaments at a distance of 4. 5cm, 4. 0cm, 3. 5cm, 3. 0cm, 2. 5cm and 2. 0cm from cervixuter.i TheTH-positive fiberswere in the middle of the ligaments at a distance of 1. 5cm fromcervix uter,i in the caudal side of the ligaments at1. 0cm and 0. 5cm. (2)Themean length of uterosacral ligamentswas6. 5cm,TheTH-positive fibers located in themedialand cephalic part of the ligaments at a distance of6. 0cmand 5. 5cm from cervix uter,i in themiddle and inferior partof the ligaments at5. 5cm, 4. 5cm, 4. 0cm, 3. 5cm, 3. 0cm, 2. 5cm and 2. 0cm, in the caudal and lateral side of the ligaments at1. 5cm, 1. 0cm and 0. 5cm. (3)Themean length ofvesicouterine ligamentswas 2. 3cm,TheTH-positive fibers located in themedial side of the vesical veins in deep layerof the