两侧部分腰大肌止端转位至盆底重建排尿功能的应用解剖

Applied anatomy on the transposition of bilateral greater psoas muscles to reconstruct urination function

在４４侧（成人３０．儿童１４）尸体上，对腰大肌在盆内的毗邻关系．该肌自髂耻隆起至股骨小转子、会阴中心腱的距高等作了说细的观测．腰大肌在盆内与周围的血管神经等位置关系恒定，变化少．该肌自髂耻隆起至股骨小转子、会阴中心腱的距离成人平均分别为１１７．１７±１０．６４ｍｍ、１０８．１９±１０．１７ ｍｍ，儿童平均分别为８５．９４±１３．８９ ｍｍ、７２．６６±９．３８ ｍｍ．根据解剖结果进行了术式的设计，即同时游离两侧部分腰大肌止端，转移至盆内与会阴中心腱直接缝合，增强盆底肌张力，重建排司法部功能，从肌的长度和解剖关系上看该术式具有可行性．

The position and syntopy of the greater psoas muscle in pelvis were observed on 44 sides of pelvic specimens (adults 30.children 14). Constant relationships between the greater psoas muscle and the adjacent nerves and vessels were recorded. The distances from iliopubic prominence to femoral lesser trochanter and perineal central tendon are respectively 117. 7±10. 64 mm and 108. 0±10. 2 mm in adult ,and 85. 9±13. 9 mm and 72. 66±9. 38 mm in children. Based on the anatomical results , it is feasible to transpose the ends of bilateral greater psosa muscles to the pelvic bottom and to suture them directly to the perineal central tendon. This operation is helpful to strengthen the muscles of pelvic bottom for urination reconstruction.