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目的:了解直肠阴道隔周围区域的断层形态结构,为妇产科、肛肠外科的相关区域病变提供可靠的解剖学依据。方法:成人尸体盆腔部标本10例,制成0.5mm厚的水平位火棉胶连续切片。结果:①直肠阴道隔的前面与阴道后壁紧贴而与直肠间空隙较大,从而导致直肠前壁的空虚,可视为直肠阴道间隙的前界。②通过在阴道后穹平面,宫颈口平面及阴道口平面的形态观察,发现直肠阴道隔呈上宽下窄,纤维组织逐渐致密的特点。直肠阴道隔的上端起自直肠子宫陷凹的底部,与阴道后壁紧贴,下端与会阴中心腱相融合。故直肠突出好发于直肠阴道隔上端。结论:直肠阴道隔是支持和悬吊直肠、阴道的关键性结构,也是维持盆腔稳定的关键因素。其上端最为薄弱,也是直肠前突最易好发的部位。修补直肠阴道隔时,也要修补松弛的会阴中心腱和周围的韧带结构等。
OBJECTIVE: To understand the morphological structure of the rectovaginal area and provide a reliable anatomic basis for the related regional lesions in the department of Obstetrics and Gynecology. Methods: 10 pelvic specimens from adult cadavers were made into serial slices of collomized cotton at the level of 0.5 mm. Results: ① The front of the rectovaginal septum and the posterior wall of the vagina are closely attached to the rectum and the gap between the rectum and the rectum is relatively large, resulting in the emptiness of the anterior rectal wall, which can be regarded as the frontal boundary of the rectovaginal space. ② In the vagina after the dome plane, cervix plane and vaginal port plane morphology observation found that the rectovaginal septum was narrow width, fibrous tissue gradually dense features. The upper part of the rectovaginal septum starts from the bottom of the uterine pouch in the rectum and is in close contact with the posterior wall of the vagina. The lower part is fused with the tendon in the center of the perineum. Therefore, rectal predominance occurs in the rectovaginal upper end. Conclusion: The rectovaginal septum is the key structure to support and suspend the rectum and vagina, and is also the key factor to maintain pelvic stability. The top of the most vulnerable, but also the most prone to rectocele hair site. Repair rectovaginal septum, but also to repair the loose perineal tendon and the surrounding ligament structure.