深部臀肌综合征的诊治进展  

The progress in diagnosis and treatment of deep gluteal syndrome

作　　者：张立宁[1,3] 陈燕 李春宝 常祺 Zhang Lining;Chen Yan;Li Chunbao;Chang Qi(Department of Rehabilitation Medicine,The First Medical Center,PLA General Hospital,Beijing 100853,China;Department 2 of Health Care,No.971 Hospital of PLA Navy,Qingdao,Shandong 266071,China;Military Training Injury Prevention and Research Center of PLA,Chinese PLA General Hospital,Beijing 100048,China;Department of Orthopedics,The Forth Medical Center,PLA General Hospital,Beijing 100048,China;Military Medical Research Institute of PLA,Hospital 989 of Joint Service Support Force of Chinese PLA,Luoyang,Henan 471003,China)

机构地区：[1]解放军总医院第一医学中心康复医学科,北京100853 [2]中国人民解放军海军第九七一医院保健二科,山东青岛266071 [3]全军军事训练伤防治与研究中心,北京100048 [4]解放军总医院第四医学中心骨科医学部,北京100048 [5]联勤保障部队第989医院全军军事训练医学研究所,河南洛阳471003

出　　处：《创伤外科杂志》2024年第5期388-393,共6页Journal of Traumatic Surgery

基　　金：北京市科技重大专项(D181100000318004)。

摘　　要：深部臀肌综合征(DGS)是一种非盘源性坐骨神经痛,常由骶髂区和臀区的创伤引起,是坐骨神经穿过深部臀肌间隙时神经干被周围的肌肉卡压引起臀部和髋关节后方疼痛,久坐或长期行走加重,包括梨状肌综合征、闭孔内隐窝综合征、坐骨股骨头撞击综合征和近端腘绳肌综合征等亚型。正确的诊断主要依据病史采集、体格检查(激惹试验、电生理检查)和影像学检查。非手术治疗包括休息、避免激惹疼痛的活动、药物、注射和物理治疗等多学科治疗,对于非手术治疗无效后持续症状或顽固疼痛的患者进行内窥镜或切开手术治疗。本研究总结了DGS的流行病学、解剖、发病机制、分型、临床症状、辅助检查、诊断和治疗,为DGS的治疗提供理论依据。Deep gluteal syndrome(DGS)is a non-discogenic sciatica caused by compression of the sciatic nerve passing through the deep gluteal muscle space.It mainly presents posterior gluteal pain or sacroiliac joint pain.Sedentary or long-term walking aggravates the pain.It includes the piriformis syndrome,the gemelli-obturator internus syndrome,the ischiofemoral impingement syndrome,and the proximal hamstring syndrome.The Careful history-taking,a physical examination including provocation tests,an electrodiagnostic study,and imaging are necessary for an accurate diagnosis.It can be conservatively treated with multidisciplinary treatment including rest,the avoidance of provoking activities,medication,injections,and physiotherapy.Endoscopic or open surgical decompression is recommended in patients with persistent or recurrent symptoms after conservative treatment.This review shares the epidemiology,anatomy,pathology,classification,clinical features,supplementary examination diagnosis and treatment of deep gluteus syndrome in order to provide theoretical basis for the diagnosis and treatment of DGS.

关 键 词：深部臀肌综合征 坐骨神经痛 臀部疼痛 

分 类 号：R745.42[医药卫生—神经病学与精神病学]