髂腹股沟下入路耻骨肌孔下区的解剖学研究

徐顺利; 吕翔; 刘自国; 王义生

doi:10.13418/j.issn.1001-165x.2014

中国临床解剖学杂志 >

2014 , Vol. 32 >Issue 6: 648 - 651

DOI: https://doi.org/10.13418/j.issn.1001-165x.2014

应用解剖

髂腹股沟下入路耻骨肌孔下区的解剖学研究

徐顺利 ,
吕翔 ,
刘自国 ,
王义生

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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

徐顺利（1976-），男，河南获嘉人，主治医师，研究方向：骨关节损伤，Tel:15936599125

收稿日期: 2014-02-15

网络出版日期: 2014-12-04

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

XU Shun-Li ,
LV Xiang ,
LIU Zi-Guo ,
WANG Xi-Sheng

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1.Department of Orthopaedics, Huojia Red-cross Hospital, Xinxiang 453800, Henan Province, China; 2.Hebi Polytechnic Medical College, Hebi 458000, Henan Province, China; 3.Department of Orthopaedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China

Received date: 2014-02-15

Online published: 2014-12-04

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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。

关键词： 髂腹股沟下入路; 耻骨肌孔; 股疝

本文引用格式

徐顺利 , 吕翔 , 刘自国 , 王义生 . 髂腹股沟下入路耻骨肌孔下区的解剖学研究[J]. 中国临床解剖学杂志, 2014 , 32(6) : 648 -651 . DOI: 10.13418/j.issn.1001-165x.2014

Abstract

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.

Key words： Subinguinal approach; Myopectineal orifice; Femoral hernia

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