臀部肌肉注射术的应用解剖

Applied anatomy on intramuscular injection in gluteal area

目的提供科学的臀部解剖学数据,确定安全的臀部肌肉注射部位。方法选取33例(66侧)成人下肢标本,在臀部外上区进行逐层解剖,观察并测量皮肤与皮下组织以及臀大肌和臀中肌的厚度;观察臀上神经的分支类型以及臀上动脉、静脉的管径。结果皮肤与皮下组织厚度男性约为1.2cm,女性约为1.4cm;臀大肌厚度男性约为1.8cm,女性约为1.5cm;臀中肌的厚度男性约为1.4cm,女性约为1.2cm。臀上神经与臀上血管的深支在臀肌之间共同形成血管神经层,多分为上、下两支,血管分别位于相应神经的下方。结论从股骨大转子到坐骨结节连线以上的臀部外上区,其下中1/3和前1/3区的上部最适宜肌肉注射,上中1/3区下部两横指处可作被选部位,其余区域不宜肌肉注射。

Objective To provide scientific anatomy data for gluteal area and determine safe intramuscular injection point in gluteal area. Methods 33 （66 sides） adult lower limbs were dissected layer by layer to observe and measure the thickness between the skin and hypodermis as well as the thickness between the gluteus maximus and gluteus medius; observe the branched type of superior gluteal nerve and the diameters of superior gluteal artery and vein. Restdts The mean thickness between skin and hypodermis was 1.2 cm for male, and was 1.4 em for female, and the mean thickness of gluteus maximus was 18 cm for male, and was 1.5 em for female. The mean thickness of gluteus medius was 1.4 cm for male, and was 1.2 cm for female. The deep branches of superior gluteal nerve together with blood vessels form vascular nerve layer, most of which divided into upper and lower branches, the blood vessel weree located under the corresponding nerve. Conclusion In the area above the line from greater trochanter to ischial tuberosity tuber, the superior portion of the inferior middle 1/3 and anterior 1/ 3 is the most suitable site to inject. Two finger wide under superior middle 1/3 can be selected as injected point.