坐骨神经鞘膜的形态学观察

doi:10.3969/j.issn.0529-1356.2014.03.014

解剖学报 ›› 2014, Vol. 45 ›› Issue (3): 369-374.doi: 10.3969/j.issn.0529-1356.2014.03.014

坐骨神经鞘膜的形态学观察

任彦红¹ 徐朝阳¹涂丽莉¹ 徐胜春^1* 梁亮²张铭^2,3

1. 安徽医科大学解剖学教研室，合肥 230032; 2. 首都医科大学解剖学教研室，北京 100069;3. 新西兰Otago大学解剖学系，达尼丁市 9054

收稿日期:2013-04-18 修回日期:2013-05-12 出版日期:2014-06-06 发布日期:2014-06-06
通讯作者: 徐胜春 E-mail:chun028@163.com

Morphological observation of the fascial sheath of the sciatic nerve

REN Yan-hong¹XU Zhao-yang¹ TU Li-li¹XU Sheng-chun^1* LIANG Liang² ZHANG Ming ^2,3

1. Department of Anatomy, Anhui Medical University, Hefei 230032, China;2. Department of Anatomy, Capital Clinical Uinversity, Beijing 100069，China;3. Department of Anatomy, University of Otago, Dunedin 9054, New Zealand

Received:2013-04-18 Revised:2013-05-12 Online:2014-06-06 Published:2014-06-06
Contact: XU Sheng-chun E-mail:chun028@163.com

摘要/Abstract

摘要：

目的明确成人盆部坐骨神经筋膜鞘存在与否及其完整性，为临床坐骨神经阻滞提供形态学依据。方法选用14具盆腔至腘窝段完整的成人坐骨神经标本，采用局部乳胶注射解剖（10例），矢状位、水平位断层解剖（2例），组织学切片（2例）和磁共振（MRI）（20例）等方法来观察坐骨神经盆腔段的形态学特点。
结果盆部乳胶未沿神经根走行扩散；断层和组织学资料显示，骶丛神经根无完整鞘膜包裹，骶丛神经和闭孔神经之间无筋膜分割；MRI结果与断层结果相符。结论坐骨神经根在成人盆腔段无完整筋膜鞘包裹，骶旁阻滞可以阻滞到闭孔神经。

关键词: 坐骨神经, 鞘膜, 断层解剖, 组织切片, 磁共振成像, 人

Abstract:

Objective To identify the configuration of the fascial sheath of the sciatic nerve in the adult pelvis. Methods A total of 14 cadaveric pelvic specimens and 20 living subjects were used for cadaveric examination and magnetic resonance imaging (MRI) observation, respectively. The cadaveric specimens were investigated by the local latex injection method (n=10) sectional anatomy (n=2) or histological staining methods (n=2). The MR images were collected and analyzed from twenty patients without pelvic disorders. Results The injected latex did not diffuse along the pelvic segment of the sciatic nerve. Sectional anatomical and histological data showed that the architecture of the fascial sheath of the sciatic nerve varied at different levels. An intact circular sheath around the nerve was rarely observed. There was no fascia barrier between the obturator and sciatic nerves. Appearance on MRI was consistent with the cadaveric observation. Conclusion No intact fascial sheath exists along the pelvic segment of the sciatic nerve, thus sciatic anesthesia may block the obturator nerve.

Key words: Sciatic nerve, Sheath, Sectional anatomy, Histological section, Magnetic resonance imaging, Human

任彦红徐朝阳涂丽莉徐胜春* 梁亮张铭 . 坐骨神经鞘膜的形态学观察[J]. 解剖学报, 2014, 45(3): 369-374.

REN Yan-hong XU Zhao-yang TU Li-li XU Sheng-chun* LIANG Liang ZHANG Ming. Morphological observation of the fascial sheath of the sciatic nerve[J]. AAS, 2014, 45(3): 369-374.

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坐骨神经鞘膜的形态学观察

Morphological observation of the fascial sheath of the sciatic nerve

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