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目的为肾盂输尿管连接处(UPJ)的形态学定位提供临床应用解剖学研究资料。方法取材于32例10%福尔马林固定的成人尸体双侧泌尿系标本,进行大体测量、组织学染色、神经纤维银染和图像分析。结果 UPJ外径(3.12±0.81)mm和内径(2.26±0.15)mm分别小于肾盂中部和输尿管中部的各自相应值(P<0.05)。UPJ神经纤维分布比肾盂中部和输尿管中部稀疏,胶原纤维较丰富。UPJ肌层厚度(0.34±0.03)mm和管壁厚度(0.63±0.04)mm也分别小于肾盂中部和输尿管中部各自相应值(P<0.05)。肾倾斜角平均为61°,与肾倾斜角有关的UPJ位置平均在肾下极平面以上1.2～1.3cm处,且肾倾斜角越大,UPJ位置相对越高。结论 UPJ约位于距肾下极平面以上1.25cm处。UPJ存在生理性内、外径狭窄,神经纤维分布较稀疏,平滑肌较薄弱,且排列不规则。
Objective To provide clinical application anatomy data for the morphological localization of ureteropelvic junction (UPJ). Methods Bilateral urinary samples from 32 adult 10% formalin-fixed adult cadavers were collected for gross measurement, histological staining, silver staining of nerve fibers and image analysis. Results The diameter (3.12 ± 0.81) mm and the internal diameter (2.26 ± 0.15) mm of UPJ were less than those of the middle of pelvis and middle of ureter (P <0.05). UPJ nerve fiber distribution than the middle of the renal pelvis and ureter sparse, more abundant collagen fibers. The thickness of UPJ myometrium (0.34 ± 0.03) mm and the wall thickness (0.63 ± 0.04) mm were also less than those of the middle of the renal pelvis and the middle of the ureter (P <0.05). The average tilt angle of the kidney was 61 °. The UPJ position related to the tilt angle of the kidney averaged 1.2 ~ 1.3 cm above the lower polar level of the kidney. The larger the tilt angle of the kidney, the higher the UPJ position. Conclusion UPJ is about 1.25cm above the plane of the lower pole of the kidney. UPJ there are physiological internal and external diameter of narrow, sparse distribution of nerve fibers, smooth muscle is weak, and arranged irregularly.