前列腺动脉解剖观测及临床应用.docVIP

前列腺动脉解剖观测及临床应用 　 作者：李光忠，张本斯，杨月如 ［摘 要］ 目的 研究成人前列腺动脉的来源、行程、进入前列腺的部位及其与神经丛的关系，为前列腺手术提供解剖学基础。 方法 在解剖显微镜下对30侧常规防腐固定的35～60岁成年男性尸体前列腺动脉及神经丛作解剖、观测。 结果 30侧均有恒定的前列腺动脉，共有125支，来源丰富，主要来自膀胱下动脉（92.125，73.6%），行程较恒定，在距膀胱前列腺间沟（22±8）mm处呈丫爪状分支，多数分支在膀胱前列腺间沟内进入前列腺底，按时钟顺序，各点钟处均有动脉进入，以3～5或7～9点居多（87.125，69.6%）。前列腺神经丛由膀胱神经丛延续而来，在接近膀胱前列腺间沟处与前列腺动、静脉相互交织成网，进入前列腺包膜中。 结论 在距膀胱前列腺间沟20～30mm处，环周结扎前列腺动脉，止血更为彻底，也可避免损伤神经丛。 　　［关键词］ 前列腺;前列腺动脉;神经丛;应用解剖 　　Anatomical observation and clinical application of the prostatic artery 　　Abstract:Objective To study the origin，course，and distribution of the prostatic artery and its anatomic relationship with the nervous plexus so as to provide anatomic foundation for the prostatectomy.Methods The origin，course，and distribution of the prostatic artery，and the relative relationship between the artery and nervous plexus on30pelvic halves of male adult cadavers embalmed routinelywith formaldehyde solution were dis-sected，observed，and measured with the Olympus anatomic microscope.Results The prostatic arteries were constant in existence and there were a total of125branches in30pelvic halves dissected.They originated from several sources and mainly from the inferior vesical artery（92.125，73.6%）.The vessels were in variably coursed，and at（22±8）mm above the groove between the urinary bladder and the base of prostate（proa-tate-bladder groove）gave off their branches to the gland.Then most of these branches entered into the base of prostate as the claws of the duck near the proatate-bladder groove to each region of prostate，mainly to3～5or7～9points of the clock（87.125，69.6%）.The prostatic nerve plexus was a continuation of the bladder nerve plexus，and mixed into a network with the arteries and veins of the prostatic gland near the proatate-bladder gro-ove.Then the network entered into the envelope of the prostate.Conclusion It is considered that annular ligation of prostatic artery at the level of 20～30mm above the proatate-bladder groove is more effective for complete hemo