筋膜穿支血管在髋关节OCM入路中解剖学定位的研究  

The research of fascia perforating vessels in the anterior-lateral approach of the hip joint

作　　者：黄宇[1] 孙晓彤[1] 尹东[1] 黄晓[1] 覃文杰[1] 

机构地区：[1]广西壮族自治区人民医院骨科,南宁530021

出　　处：《中国临床新医学》2015年第8期720-722,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西卫计委科研课题(编号:Z2012308)

摘　　要：目的：探寻在髋关节前外侧（ OCM）入路中筋膜穿支血管与肌间隙及神经界面的关系。方法解剖经甲醛溶液常规防腐固定处理33侧髋部，均无肢体畸形及手术史。探查髂前上棘至大转子外侧最凸处连线附近血管穿筋膜点并探明该血管与臀中肌阔筋膜张肌肌间隙的位置及臀上神经的关系；观察在2011－06～2013－06间在我科行87台髋关节前外侧入路手术中发现筋膜穿支血管及其与臀中肌阔筋膜张肌肌间隙的位置关系。结果臀中肌与阔筋膜张肌肌间隙所在附近筋膜表面血管位置较为恒定。在尸体标本中约91％（30例）的标本在肌间隙中部可见穿支血管，穿支血管均来自肌间隙深面。在髋关节置换手术中发现有筋膜穿支血管的约为90．8％（79例），血管均来自肌间隙深面。臀上神经入肌点与筋膜穿支血管最短距离为（5．62±1．18） cm，安全范围与股骨长度及髂嵴最高点与大转子外侧最凸处的距离均有明显相关关系，相关系数分别为0．84、0．61。结论筋膜穿支血管与臀中肌阔筋膜张肌肌间隙关系恒定，在髋关节置换OCM入路中采用筋膜穿支血管定位准确，安全。Objectiv e To observe the relationship between fascia perforating vessels with muscle gap and neural interface in the anterior-lateral approach of the hip join .Methods 33 hips of dead bodies with formaldehyde solution embalmed , and without limb deformity and operation history were anatomised .The fascia vessel near point in the anterior superior iliac spine to the lateral trochanter at the most convex line was explored , and the relationships between the vessels with muscle gap and neural interface were recorded .The numbers of fascia perforating vessels and the position of the muscle gap in 87 hip operations were observed in our department from June 2011 to June 2013 .Re-sults The fascia vascular had constant position in the muscle gap of the gluteus medius muscle and the tensor fascia was found in 30 cases（about 91%）of the specimens.The perforating vessels were found and they came from the deep surface of muscle celearance .The perforating vessels were found in79 cases（90.8%） who were performed the opera-tion and the peforating vessels came from the deep surface of muscle celearance .The shortest distance from the supe-rior gluteal nerve entry point to fascia latal perforator was （5.62 ±1.18）cm.There were correlations between the safe range with femur length , the iliac crest and the rotor outside the convex distance （ r=0.84,0.61 ） .Conclusion There is a constant relationship between the postion of the fascial lata perforator vessel with the muscle gap of the glu -teus medius muscle and the tensor fascia. The fascial perforating vessels can provide accurate and safe positioning for the OCM approach of the hip join .

关 键 词：筋膜穿支血管 髋关节 OCM入路 肌间隙 

分 类 号：R687.4[医药卫生—骨科学]