臀中肌滋养血管在臀肌挛缩症松解术的应用解剖.pdfVIP

齐齐哈尔医学院学报2007年第28卷第21期 臀中肌滋养血管在臀肌挛缩症松解术的应用解剖 沈 雷 李永涛 钟震亚 【摘要】 目的 根据臀中肌及其周围组织的局部解剖，重点解剖、观察臀中肌滋养血管，探讨臀肌 挛缩症术式改良及其注意事项。方法 解剖无下肢疾患的8例16侧成人尸体臀部标本，观察滋养臀中 肌的起点、入肌点以及分支、分布。结果 臀中肌的血供主要来自臀上动脉的深支，入肌点在臀中肌的 内侧缘深面，髂后上棘下方者占81．25 ，髂后下棘上方者占l8．75 ，一般分为2～3支，臀中肌下方内 侧区尚有少量臀下动脉分布。结论 手术松解挛缩组织时应在臀中肌上部偏外沿肌纤维方向进行，宜 靠近股骨大转子，以尽量避免血管神经的不必要损伤，同时可避免损伤髋关节。 【关键词】 臀肌挛缩症 臀中肌 动脉 Applied anatomy of trophoblast vascular of Gluteus Medius in gluteal muscle contracture release Shen Lei，el a1． (Department of Anatomy，Qiqihar Medical College，Qiqihar，Heilongjiang 161042 China) [AbstracI】 Objective According to the local dissection of gluteus medius and the pathological dis— section of gluteus medius contracture 10 discuss the modified operational improvement and attentions pro— ceeding of the operation．Methods Anatomy of the patients with no leg disease 8 cases 1 6 adult corpses side buttocks specimens，observing the starting point of trophoblast gluteal medius，the muscle points and branch distribution．Results Blood of gluteal medius was supplied from the main artery of the deep branch of superior and inferior gluteal artery，the muscle points are located in the deep side edge of glute— US medius，posterior superior iliac spine possesses 81．25 ，anterior superior iliac spine takes 18．75 ， it is usually divided into 2 branches，there are some inferior gluteal arteries under the inside gluteus me— dius．Conclusions When contracture release surgery organization，the muscle fiber over the gluteus me— dius should be moved forward．It will be better near the greater trochanter to avoid unnecessary damage blood vessels and nerves and hip joint can also be avoided． [Key words] Glutecl muscle contracture Gluteus medius Artery 臀肌挛缩症是现代小儿常见疾病，在I临床上臀 线为B线，以髂后上嵴至髂前上嵴连线为C线，C、A 肌挛缩症松解术是治疗本病的根本办法。臀肌挛缩 线相交为D点，B、C线相交为E点，大转子为F点， 症的病变往往以臀大肌和臀中肌纤维化挛缩为主， 髂后上棘为G点(图1)，将三线三点围成的DEF三 大多数学者对臀大肌的解剖报道较多 ，但与该 角形区域称为髂转骶三角。三条