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目的测量臀肌悬带的相关解剖学参数,为国人解剖学数据提供资料,同时为临床通过切除臀肌悬带降低坐骨神经麻痹发生率提供解剖学依据。方法选择国人成人尸体下肢标本24例,测量其臀肌悬带以及其与坐骨神经、第1穿动脉、股骨大转子尖和坐骨结节的关系。结果臀肌悬带的长度为(8.68±0.80)cm;悬带的近侧端和股骨大转子尖之间的距离为(6.57±0.92)cm;坐骨结节后尖的臀大肌纤维和悬带近侧端距离为(5.56±0.71)cm;悬带近侧2/3末端与坐骨结节的连线与坐骨神经夹角为(42.2±5.4)°;坐骨神经外侧缘与悬带近、远侧端之间的最小横向距离分别为(2.93±0.56)cm和(2.30±0.42)cm;大转子尖和第1穿动脉的距离为(10.84±0.54)cm;大转子尖和第1穿动脉升支的距离为(8.77±0.58)cm;悬带近端到第1穿动脉的距离为(3.84±0.53)cm;悬带近端到第1穿动脉升支的距离更近,为(1.78±0.93)cm。结论切断悬带近侧端约6cm就足以释放坐骨神经压力而不必完全切除悬带。第1穿动脉特别是其升支与臀肌悬带极为接近,极易受损,解剖分离后者与周围结构时,应极为谨慎。
Objective To measure the anatomical parameters of the sphincter of the gluteus muscle and provide anatomical data for the anatomical data of the Chinese people. At the same time, to provide an anatomical basis for reducing the incidence of sciatic nerve paralysis by removing the gluteus sphincter. Methods Twenty-four adult cadaveric lower extremities were selected and their gluteal sphincter and its relationship with the sciatic nerve, the first perforating artery, the greater trochanter of the femur and the ischial tuberosity were measured. Results The length of the sphincter of the gluteus muscle was (8.68 ± 0.80) cm. The distance between the proximal end of the sling and the greater trochanter of the femur was (6.57 ± 0.92) cm. (5.56 ± 0.71) cm at the proximal end; the angle between the connection of the proximal 2/3 end of the sling and the ischial tuberosity and the sciatic nerve was (42.2 ± 5.4) °; the lateral margin of the sciatic nerve was close to the sling, the distal end (2.93 ± 0.56) cm and (2.30 ± 0.42) cm respectively; the distance between the greater trochanter and the first perforating artery was (10.84 ± 0.54) cm; the greater trochanter and the artery of the first artery were (8.77 ± 0.58) cm. The distance between the proximal side of the sling and the first artery was (3.84 ± 0.53) cm. The distance between the proximal side of the sling and the ascending artery of the first artery was closer (1.78 ± 0.93) ) cm. Conclusion Cutting off the proximal side of the sling by about 6 cm is sufficient to release the sciatic nerve without having to completely remove the sling. The first perforating artery, especially its ascending and gluteal sling is very close, easily damaged, anatomical separation of the latter and the surrounding structure, should be extremely cautious.