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目的研究基于新鲜组织连续切片数据集构建子宫骶骨韧带内神经脉管的数字化三维模型。方法选择2014年8月于南方医科大学南方医院因宫颈鳞状细胞癌ⅠB1期行经腹广泛性子宫切除术的新鲜右侧子宫骶骨韧带标本1例,标本外侧缘取切片经病理学检查证实无癌细胞浸润。用印度墨水标记韧带宫颈侧与上缘,标本常规固定、脱水后,利用穿刺针穿取4条略长于标本的猪肝组织(直径约0.5mm)作为定位杆标记,与标本一起进行石蜡包埋,从宫颈侧开始连续切片,切片厚度5μm,连续5张为一组分别进行HE染色、动脉弹力纤维特殊染色及免疫组织化学特殊染色。对所有连续切片进行图像采集、融合,并对其进行配准。利用计算机三维重建软件构建出子宫骶骨韧带内神经与脉管数字化三维模型。结果成功利用组织连续切片数据集构建出子宫骶骨韧带及其内神经与脉管的数字化三维模型。结论通过观察重建的数字化三维模型,可清楚地显示出交感神经、副交感神经、血管及淋巴管在子宫骶骨韧带内的走行分布及立体关系,为系统保留盆腔自主神经的广泛性子宫切除术步骤的规范化提供依据。
Objective To study the digital three-dimensional model of the nerve vasculature in the uterosacral ligaments based on the continuous slicing data set of fresh tissue. METHODS: One case of fresh right uterosacral ligament specimens from the right lateral uterine hysterectomy for cervical squamous cell carcinoma ⅠB1 in Nanfang Hospital, Southern Medical University in August 2014 was selected. The specimens from the lateral margin of the specimen were confirmed by pathology to be non-cancerous Cell infiltration. The Indian side of the ligament cervix and the upper edge of the mark, the specimen routinely fixed, dehydration, the use of puncture needle puncture four slightly longer than the specimen of liver tissue (diameter of about 0.5mm) as a positioning rod mark with paraffin embedding , Serial sections from the cervix side, slice thickness 5μm, continuous 5 for a group were HE staining, arterial fiber special staining and immunohistochemical staining. All serial sections were imaged, fused, and registered. Using computer three-dimensional reconstruction software to construct a digital three-dimensional model of nerve and vessel in uterosacral ligament. Results The digitized three-dimensional model of the uterosacral ligaments and their inner nerves and vessels was successfully constructed using the serial tissue section data. Conclusion By observing the reconstructed digital three-dimensional model, the distribution of the sympathetic nerves, parasympathetic nerves, blood vessels and lymphatic vessels in the uterosacral ligaments and the three-dimensional relationship can be clearly shown, and the procedure of extensive hysterectomy for pelvic autonomic nerve preservation Standardization provides the basis.