闭孔神经在闭膜管外的解剖学测量及临床意义  

Anatomic Measurement of the Obturator Nerve Outside the Closed Tubular and Its Clinical Significance

作　　者：张孝林[1] 刘杨[1] 张辉[1] 马炜 侯燕红[3] 

机构地区：[1]长治医学院临床一系,2015级046000 [2]长治医学院影像系 [3]长治医学院解剖学教研室

出　　处：《长治医学院学报》2017年第6期409-410,438,共3页Journal of Changzhi Medical College

基　　金：山西省高等大学生创新创业训练项目(2014307)

摘　　要：目的:测量闭孔神经在闭膜管外的解剖位置,为不同路径的闭孔神经阻滞麻醉提供必要的解剖学数据支撑。方法:取福尔马林溶液固定的成人尸体25具,进行盆腔解剖,显露闭孔神经的全貌、闭孔周围及股部的解剖结构。结果:闭膜管内侧壁距耻骨结节的距离为(41.53±0.76)mm;闭膜管外侧壁距耻骨结节的距离为(54.17±0.42)mm;闭孔神经距股静脉内侧壁的距离为(11.01±0.17)mm;闭孔神经穿出点距腹股沟韧带中、内1/3交点的垂直距离为(27.92±0.33)mm;闭孔神经出闭孔点距耻骨结节的距离为(23.55±0.27)mm。结论:闭孔神经阻滞麻醉时的进针部位选在腹股沟韧带中、内1/3交点垂直向下27.59~28.25mm与耻骨结节的外下至该线距离23.28~23.82mm范围内,为安全有效的麻醉范围,且操作时针尖应向后、外、上方刺入,使针尖滑过耻骨水平支下缘,可提高闭孔神经阻滞麻醉成功率。Objective:To provides necessary anatomic data support for obstructive anesthesia of obturator nerve in different pathways by measuring the anatomical structure of the obturator nerve beyond the pericardial ducti.Methods:25 formalin fixed adult cadavers were taken to have pelvic dissection,revealing the entire obturator nerve,the closed-cell and femoral anatomy.Results:The distance between inner wall of cavitas pelvis tube and pubic tubercle is(41.53±0.76)mm;The distance from the pubic tubercle to the lateral wall of obturator canal is(54.17±0.42)mm;the distance from the femoral vein to obturator nerve about(11.01±0.17)mm;the direct distance from exit point of obturator nerve to inguinal ligament is(27.92±0.33)mm;the distance from point of obturator nerve out the obturator hole to pubic tubercle is(23.55±0.27)mm.Conclusion:Obturator nerve block anesthesia needle into parts of the persons to be in:the inguinal ligament,inside a third intersection straight down 27.59~28.25 mm and outside next to the line of the pubic bone nodules from 23.28~23.82 mm,within the scope of the range for the safe and effective anesthesia;Furthermore,in operation,the tip should be thrust backward,outward and above,so that the tip of the needle can slip through the lower margin of the pubic bone,which can improve the success rate of the anesthesia of the obturator nerve block.

关 键 词：闭孔神经 闭膜管外 腹股沟韧带 耻骨结节 测量 临床意义 

分 类 号：R323[医药卫生—人体解剖和组织胚胎学]