髂腹股沟下入路耻骨肌孔下区的解剖学研究  

Anatomical study of the inferior area of myopectineal orifice in subilioinguinal approach

作　　者：徐顺利 吕翔 刘自国[2] 王义生[3] 

机构地区：[1]获嘉县红十字医院骨科,河南新乡453800 [2]鹤壁职业技术学院医学院,河南鹤壁458000 [3]郑州大学第一附属医院骨科,郑州450000

出　　处：《中国临床解剖学杂志》2014年第6期648-651,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的对耻骨肌孔下区解剖结构进行重新认识,为髂腹股沟下入路术后股疝的预防提供解剖学依据。方法 20具尸体分层解剖观测耻骨肌孔下区结构,结合外科疝的理论对髂腹股沟下入路术后股疝的原因和预防进行分析探讨。结果耻骨肌孔下区为上长下短的近似梯形结构,血管鞘及其前后连接、陷窝韧带及耻骨肌筋膜等为其封闭结构,但存在多个薄弱部位,手术损伤易造成缺损导致股疝。结论耻骨肌孔下区薄弱处均为股疝可能发生的部位,采用髂腹股沟下入路方法时需尽量避免损伤或加强术后重建。Objective To re-understandthe structure of inferior area of myopectineal orifice to offer the anatomic evidence for prevention of femoral hernia after operation of acetabulum fracture via subilioinguinal approach. Methods Twenty human adult cadavers were dissected in the Anatomy Department at Xinxiang Medical College. The anatomical structures in the inferior area of myopectineal orifice includingfemoral sheath, lacunar ligament and pecten pubis fascia that may be exposed in the subilioinguinal approach were observed and documented. Results The shape of the inferior area of myopectineal orifice was similar to being ladder-shaped and the sealing structures included vagina vasorum, lacunar ligament and pectineus muscular fasciae. However, there were multiple domains in the inferior area of myopectineal orifice were weak enough to induce the femoral hernia. Conclusion The weak domains of the inferior area of the myopectineal orifice were the possible location for occurrence of femoral hernia, which required protection and/or reconstruction.

关 键 词：髂腹股沟下入路 耻骨肌孔 股疝 

分 类 号：R323.5[医药卫生—人体解剖和组织胚胎学]