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目的 通过对肛管周围解剖关系的观察 ,分析肛管直肠角形成和维持的解剖机制 ,为临床提供形态学参考依据。方法 从盆部侧方对 5 9例小儿肛直肠周围相关结构进行了层次解剖观察和测量。结果 会阴体是由会阴深、浅横肌、球海绵体肌、前列腺提肌 (或耻骨阴道肌 )和肛门外括约肌前部纤维交织而成的腱质结构 ,肛管前壁上部的直肠纵肌和肛门内括约肌也向前呈角状突起 ,融合于会阴体。耻骨直肠肌与前列腺提肌 (或耻骨阴道肌 )共同起于耻骨支后面和肛提肌腱弓前部 ,位于耻骨尾骨肌外下方同一层次上 ,两者间无明显分界。前列腺提肌 (或耻骨阴道肌 )止于会阴体 ;耻骨直肠肌在肛直曲后方与对侧同名肌的肌束接续形成袢。结论 由于肛管前壁上部牢固地固定于会阴体 ,会阴体及与之相连的前列腺提肌 (或耻骨阴道肌 )是除耻骨直肠肌以外另一个对肛管直肠角形成和维持的结构因素。耻骨直肠肌和前列腺提肌 (或耻骨阴道肌 )无论在形态上还是在功能上都应视为一个整体 ,两者分别牵拉肛直前、后角向前上方 ,在上提肛管的同时加曲肛直角。由于会阴体在盆底中央位置相对固定 ,肛直前、后角在排便与排便控制过程中变动的幅度有较大的差别。
Objective To observe the anatomic relationship around the anal canal and analyze the anatomic mechanism of the formation and maintenance of the anal canal in order to provide a morphological reference for clinical practice. Methods From the side of the pelvis, the anatomical observation and measurement of the structures around the anorectal in 59 infants were carried out. Results The perineal body was formed by periapical structures of perineal deep, superficial transverse muscle, ball cavernous muscle, prostatic levator ani (or pubococcygeal muscle) and anterior external anal sphincter. The longitudinal rectum longitudinal muscle in the upper part of the anterior anal canal And the anal sphincter also forward angular projection, fusion in the perineal body. Puborectalis muscle and prostate levator (or pubis vaginal muscle) together in the pubic branch and anterior levator ani tendon arch, located in the same level below the pubococcygeal muscle, there is no obvious demarcation between the two. Prostate levator (or pubis vaginal muscle) ends in the perineal body; puborectalis in the anus straight after the song and the opposite side of the same muscle muscle bundle formation 袢. Conclusions Since the upper part of the anterior wall of the anal canal is firmly fixed to the perineal body, the perineal body and its associated prostatic levator (or pubococcygeal muscle) are the structural elements that form and maintain the rectum of the anal canal in addition to the puborectalis. The puborectalis and prostate levator (or pubis vaginal muscles) both in form and function should be considered as a whole, the two were pulled before the anus, after the angle to the top of the former, while mentioning the anal canal at the same time plus Qu anal right angle. As the perineal body in the pelvic floor at the center of the relative fixed, anal anterior and posterior horn in the defecation and defecation control changes in the magnitude of a greater difference.