坐骨神经鞘膜的形态学观察  

Morphological observation of the fascial sheath of the sciatic nerve

作　　者：任彦红[1] 徐朝阳[1] 涂丽莉[1] 徐胜春[1] 梁亮[2] 张铭[2,3] 

机构地区：[1]安徽医科大学解剖学教研室,合肥230032 [2]首都医科大学解剖学教研室,北京100069 [3]新西兰Otago大学解剖学系

出　　处：《解剖学报》2014年第3期369-374,共6页Acta Anatomica Sinica

摘　　要：目的明确成人盆部坐骨神经筋膜鞘存在与否及其完整性,为临床坐骨神经阻滞提供形态学依据。方法选用14具盆腔至腘窝段完整的成人坐骨神经标本,采用局部乳胶注射解剖(10例),矢状位、水平位断层解剖(2例),组织学切片(2例)和磁共振(MRI)(20例)等方法来观察坐骨神经盆腔段的形态学特点。结果盆部乳胶未沿神经根走行扩散;断层和组织学资料显示,骶丛神经根无完整鞘膜包裹,骶丛神经和闭孔神经之间无筋膜分割;MRI结果与断层结果相符。结论坐骨神经根在成人盆腔段无完整筋膜鞘包裹,骶旁阻滞可以阻滞到闭孔神经。Objective To identify the configuration of the fascial sheath of the sciatic nerve in the adult pelvis . Methods A total of 14 cadaveric pelvic specimens and 20 living subjects were used for cadaveric examination and magnetic resonance imaging （ MRI） observation , respectively .The cadaveric specimens were investigated by the local latex injection method （ n =10 ） sectional anatomy （ n=2 ） or histological staining methods （ n =2 ） .The MR images were collected and analyzed from twenty patients without pelvic disorders .Results The injected latex did not diffuse along the pelvic segment of the sciatic nerve .Sectional anatomical and histological data showed that the architecture of the fascial sheath of the sciatic nerve varied at different levels .An intact circular sheath around the nerve was rarely observed .There was no fascia barrier between the obturator and sciatic nerves .Appearance on MRI was consistent with the cadaveric observation.Conclusion No intact fascial sheath exists along the pelvic segment of the sciatic nerve , thus sciatic anesthesia may block the obturator nerve .

关 键 词：坐骨神经 鞘膜 断层解剖 组织切片 磁共振成像 人 

分 类 号：R323.3[医药卫生—人体解剖和组织胚胎学]