人子宫骶韧带的解剖组织学特征和相关生物力学研究进展

doi:10.12280/gjfckx.20230290

摘要/Abstract

摘要：

盆腔器官脱垂（pelvic organ prolapse，POP）是一种由多因素介导的骨盆支持结构减弱引起的疾病，其主要危险因素是多胎妊娠和阴道分娩，然而POP的病理生理学过程目前尚不清楚。手术是治疗中重度POP的主要方法之一，与子宫骶韧带（uterosacral ligament，USL）相关的术式对恢复顶端支持具有重要作用，且手术成功率高。然而，术后复发和并发症的发生风险依然存在，这主要是因为术者对USL的解剖组织学和生物力学知识缺乏足够了解。准确认识USL的解剖位置和组织构成不仅有助于寻找USL最适合悬吊的位点，还可以避免术中损伤邻近的器官组织，如输尿管、直肠和神经血管等。此外，对USL各部分生物力学性能的全面认识还可以为POP发病机制的研究、预防策略和个性化手术的制定提出新的解决办法。

关键词: 子宫, 韧带, 盆腔器官脱垂, 解剖学, 组织学, 生物力学现象

Abstract:

Pelvic organ prolapse (POP) is a disease caused by weakened pelvic support structures mediated by mutiple factors. The primary risk factors are multiple pregnancies and vaginal deliveries. However, the pathophysiological process of POP is not yet known. Surgery is one of the most important methods of treating moderate to severe POP. Surgical procedures associated with the uterosacral ligament (USL) play an important role in restoring apical support and have a high surgical success rate. However, the risk of postoperative recurrence and complications are still present, largely due to a lack of adequate knowledge of the USL anatomy histology and biomechanics. Accurate knowledge of the anatomical location and tissue composition of the USL not only allows finding the most suitable site for USL suspension, but also prevents intraoperative damage to adjacent organs and tissues, such as the ureter, rectum, nerves and blood vessels. In addition, a comprehensive understanding of the biomechanical properties of the various components of USL can also suggest new solutions for the study of POP pathogenesis, prevention strategies and customization of personalized surgery.

Key words: Uterus, Ligaments, Pelvic organ prolapse, Anatomy, Histology, Biomechanical phenomena

薛凤琴, 赵书睿, 赵烨. 人子宫骶韧带的解剖组织学特征和相关生物力学研究进展[J]. 国际妇产科学杂志, 2023, 50(6): 606-612.

XUE Feng-qin, ZHAO Shu-rui, ZHAO Ye. Advances in the Anatomical and Histological Characteristics of the Human Uterosacral Ligament and Related Biomechanical Studies[J]. Journal of International Obstetrics and Gynecology, 2023, 50(6): 606-612.

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