股神经周围筋膜及其毗邻结构的解剖

Anatomy of the femoral fascia sheath and its adjacent structures

目的探讨股神经周围是否存在完整的筋膜鞘以及股神经与周围筋膜的解剖学关系,为下肢外周神经阻滞麻醉的选择提供形态学依据。方法选择5具10%福尔马林固定的两侧第1腰椎至大腿中段保存完整的标本进行研究,共10侧;其中8侧由远端向近端逐步注射乳胶后局部解剖观察,1具标本即2侧经-35℃冷冻1周后制成横断面连续断层切片,行断层解剖观察。结果本实验未发现股神经周围存在完整筋膜鞘。股神经周围有筋膜样结构包绕,从近端向远端主要包括腰丛筋膜、腰大肌肌间隔、髂筋膜及疏松的脂肪组织。结论大体解剖学观察股神经周围并不存在完整筋膜鞘。

Objective To determine if a femoral nerve ＂sheath＂ exists and provide anatomic basis for the lower limb nerve block. Methods Ten sides of lumbar and thigh regions from 5 formalin-fixed cadavers were used in this study. Eight out of 10 specimens were injected with latex using a step-by-step injection method from the distal to the proximal and dissected for topographic anatomy examination. The other two sides from the same body were deep frozen at - 35~C for a week, cut with a handsaw and used for sectional anatomy examination. Results An intact femoral nerve ＂faseial sheath＂ was not observed in the specimens examined in this study. The nerve was surrounded by various fascia-like structures. From the proximal to the distal, those fascia-like structures were the fascia of lumbar plexus, fascial septum of the psoas, the iliac fascia and loose connective tissue covering the femoral nerve. Conclusion At the gross anatomy level, an intact femoral nerve ＂faseial sheath＂ may not exist.