髂腹股沟入路相关解剖学研究

The Study on Anatomy Related to Ilioinguinal Approach

目的：为髂腹股沟入路如何避免易损伤结构提供解剖学依据。方法：对20侧成尸骨盆标本，按照手术进路的层次对相关结构和神经血管进行解剖观测。结果：（1）髂外血管与闭孔血管的吻合支直径为（2.56±0.72）mm，与耻骨联合的距离为（52.41±8.12）mm。（2）股神经由腰大肌和髂肌间穿出处至腹股沟韧带间的距离为（32.58±3.97）mm，在穿腹股沟韧带处与腹股沟韧带的垂直距离为（14.33±3.00）mm。（3）坐骨神经出骨盆时，与坐骨大切迹的距离为（15.53±3.6）mm。结论：在手术先后显露耻骨上支、髂窝及坐骨大切迹时，注意不要损伤髂外血管与闭孔血管的吻合支、股神经和坐骨神经。

Objective：To provide anatomical data for ilioinguinal approach, in order to avoiding injuries of blood vessels and nerves. Methods：Twenty pelvises from adult cadavers were dissected to observe anatomical structures including blood vessels and nerves along with operative approaches. Results：The average diameter of vascular connections between obturator vessel and external iliac vessels was （2.56±0.72） mm. The distance from the midpoint of vascular anastomosis to pubic symphysis was （52.41±8.12）mm; the point at which femoral nerve exiting from greater psoas muscle and iliac muscle to inguinal ligament was （32.58±3.97） mm; the point where sciatic nerve exiting from pelvis to great sciatic notch was（15.53±3.6）mm. The vertical dimension from the point where femoral nerve stepping over inguinal ligament to inguinal ligament was （14.33±3.00）mm. Conclusions： When exposing the superior ramus of pubis, iliac fossa and greater sciatic notch successively, we must pay close attention to the vascular connections between obturator vessel and external iliac vessels, femoral nerve and sciatic nerve.