【摘要】 目的:研究针刀治疗坐骨神经盆壁通道狭窄症的手术入路。方法:在30侧成年尸体的臀区观测了坐骨神经出梨状肌下孔后的横径、纵径及其盆壁通道的构成、大小、长度等;梨状肌出盆处的宽度、厚度、上下缘距体表的距离;以及上述结构相应的表面解剖观测。结果:测得坐骨神经出梨状肌下孔处(通道起点)的横径为(15.01±3.56)mm,纵径为(4.69±1.75)mm;平股方肌下缘处横径(14.02±2.15)mm,纵径为(4.06±1.17)mm。测得通道长(65.35±7.81)mm,通道起点与棘角线的距离为(53.12±7.72)mm。测得梨状肌出盆处的宽度为(33.03±3.06)mm,厚度为(13.68±3.57)mm。结论:据此讨论明确了形成坐骨神经盆壁通道狭窄症的解剖学机制,同时注意针刀进刀时不应使刀口线垂直于坐骨神经干划切,进刀抵达病灶后应使针刀体稍偏神经干的外侧操作,以免损伤结构。更多还原

【Abstract】 Objective:To study operative approach of knife needle for the treatment of stenosis of sciatic nerve at pelvic walls channels.Methods:The buttock of 30 adult corpses were dissected and following data were measured:the transverse and sagittal diameter of sciatic nerve after going out through infrapiriform foramen,the construct,size and length of pelvic wall channel,the width and thickness of piriformis traversing the pelvis,the distance from superior and inferior border of piriformis to body surface,as well as above-mentioned structure corresponding anatomically to the body surface.Results: The transverse and sagittal diameter of sciatic nerve after passing through infrapiriform foramen were (15.01±3.56) mm and (4.69±1.75) mm respectively,and the transverse and sagittal diameter of sciatic nerve at inferior border level of musculus quadratus femoris were (14.02±2.15) mm and (4.06±1.17) mm respectively.The length of the channels was (65.35±7.81) mm,and the distance from the starting point of channel to the line of posterior superior iliac spine and sacral cornu were (53.12±7.72) mm.The width and the thickness of piriformis passing through pelvis were (33.03±3.06) mm and (13.68±3.57) mm respectively.Conclusion: Anatomical mechanism of stegnosis sign of sciatic nerve at pelvic walls channels was darified in the present study.So in the treatment of this disease with knife needle,the knife edge line should not be vertical to sciatic nerve shaft when knife approaches,and knife needle body should slightly lean to lateral side of nerve shaft when operation is done at affected points,so as to prevent local vessles and other nevers from injury.更多还原