臀大肌下间隙软组织肉瘤屏障切除术相关问题探讨  

Barrier resection of the buttock soft tissue sarcoma

作　　者：江仁兵[1] 白靖平[1] 锡林宝勒日 龚磊[1] 何祖胜[1] 周阳[1] 

机构地区：[1]新疆医科大学附属肿瘤医院骨与软组织肿瘤科,乌鲁木齐830011

出　　处：《中国临床解剖学杂志》2011年第3期353-355,360,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的探讨臀大肌下间隙软组织肉瘤屏障切除术可行性和并发症的防治。方法⑴对3具6侧成人臀部标本的臀肌筋膜、臀大肌下间隙各壁组成、臀上动脉、坐骨神经出盆处进行解剖观察。⑵对15例臀部软组织肉瘤屏障切除术的治疗结果进行分析。结果 （1）臀大肌下间隙各壁的肌肉、肌腱、韧带、筋膜对软组织肉瘤生长具有屏障作用。（2）臀上动脉出盆处并不游离,在坐骨大孔内缘1 cm左右有一层致密的纤维结缔组织包绕固定臀上动脉。（3）坐骨神经与梨状肌下孔之间间隙较疏松,表面有一层脂肪组织。（4）15例病例,术后随访6~36个月,平均24个月,12例无瘤生存,2例出现转移而死亡,1例复发后放弃治疗。所有病人术后均出现程度不等的下肢跛行。3例臀上血管损伤出血,咬除部分髂骨骨质结扎止血。结论 （1）屏障切除术适用于臀大肌下间隙软组织肉瘤;（2）臀上动脉的损伤可以通过切除部分髂骨骨质进行结扎止血。Objective To explore the feasibility of barrier resection to treat the buttock soft tissue sarcoma and prevent the related surgical complications.Methods（1）The gluteal fascia,the walls of the subgluteus maximus space,superior gluteal artery and sciatic nerve of the pelvic extius were observed on the six specimens.（2） The therapeutic results were analyzed on 15 cases suffered from soft tissue sarcoma of the buttock.Results（1） The muscle,tendon,ligaments and fascia on the subgluteus maximus space have barrier effects on stopping the development of the soft tissue sarcoma of the buttock.（2） The gluteal artery on the pelvic extius was surrounded by fibrous connective tissue at the internal edge of the greater sciatic formaen about 1cm.（3） The loosed space between sciatic nerve and infrapiriform foramen was surrounded by adipose tissue.（4）In 15 cases followed up about 6 to 36 months,averagely 24 months,12 were free of disease,2 died from pulmonary metastasis,1 given up the treatment after recurrence.All patients appeared lower limb claudication,3 suffered from superior gluteal artery damage and followed hemostasis treatment.Conclusions（1） Barrier resection is an ideal method for treating soft tissue sarcoma of the buttock.（2） Iliac bone incision is the suitable way to prevent the bleeding of superior gluteal artery during the operation.

关 键 词：臀大肌下间隙 屏障切除术 软组织肉瘤 

分 类 号：R323[医药卫生—人体解剖和组织胚胎学]