小针刀治疗梨状肌综合征相对安全区的解剖学研究

曲靖师范学院学报 ›› 2017, Vol. 36 ›› Issue (6): 41-44.

小针刀治疗梨状肌综合征相对安全区的解剖学研究

晏廷亮¹,方杰¹,张帆²,符开俊³

1.曲靖医学高等专科学校基础医学部,云南曲靖 655011;
2.贵州医科大学生理教研室,贵州贵阳 550000;
3.曲靖市中医医院,云南曲靖 655000

收稿日期:2017-09-19 出版日期:2017-12-10
作者简介:晏廷亮,曲靖医学高等专科学校基础医学部副教授,主要从事生理学研究.

Antomical and Applied Research of Needle Knife Subcutaneous Release Operation in the Relatively Safe Region for Piriformis Syndrome

Yan Tingliang¹, Fang Jie¹, Zhang Fan², Fu Kaijun³

1.Department of Basic Medicine, Qujing Medical College, Qujing Yunnan, 655011;
2.Department of Physiology, Guizhou Medical University, Guiyang Guizhou, 550000;
3.Qujing Gity Chinese Medicine Hospital, Qujing Yunnan, 655000, China

Received:2017-09-19 Published:2017-12-10

摘要/Abstract

摘要： 通过局部解剖112侧臀部标本(包括尸体局部标本),研究探讨臀部手术操作的相对安全区(relatively safe region,RSR),为小针刀皮下松解术治疗梨状肌综合征提供解剖学依据,并在临床验证相对安全区小针刀皮下松解术治疗梨状肌综合症的可行性.研究发现臀上神经最下支(most inferior branch,MIB)的体表投影与大转子外侧最凸点之间形成了一个扇形区域,该区域在一定空间范围内无明显重要神经血管分布, 为手术操作的相对安全区,在此区域内进行小针刀皮下松解术不会损伤重要神经、血管.临床应用20例,经12~18个月随访,术后患者症状明显改善,均无神经血管损伤等严重并发症.

关键词: 小针刀皮下松解术, 相对安全区, 梨状肌综合征

Abstract: Based on the dissection of the hips of 112 cadavers (including the local specimen of the corpse) , research was conducted to determine RSR (the relatively safe region) of the operation, to provide anatomical basis for the treatment of Piriformis Syndrome by needle knife subcutaneous release operation, and to check the feasibility in clinical validation of RSR of needle knife subcutaneous release operation in the treatment of piriformis syndrome.Results showed that the scalloped area enclosed by the projective line of inferior branch of superior gluteal nerve and the most lateral protrusive point of the greater trochanter was the relatively safe region; there were not important nerves and blood vessels in this region, so it would not damage the nerve and blood vessels while operating in this region.The 20 subject patients were closely observed for about 12 to 18 months after operation. All of their situations were significantly improved. What’s more, no nerve and vasculars injury and other severe complications occurred to them.

Key words: needle knife subcutaneous release operation, relatively safe region , Piriformis Syndrome

中图分类号:

R246.9

晏廷亮,方杰,张帆,符开俊. 小针刀治疗梨状肌综合征相对安全区的解剖学研究[J]. 曲靖师范学院学报, 2017, 36(6): 41-44.

Yan Tingliang, Fang Jie, Zhang Fan, Fu Kaijun. Antomical and Applied Research of Needle Knife Subcutaneous Release Operation in the Relatively Safe Region for Piriformis Syndrome[J]. JOURNAL OF QUJING NORMAL UNIVERSITY, 2017, 36(6): 41-44.

参考文献

[1]Hu W J, Zhai J K, Cao P G, et al. The clinical application of treating piriformis syndrome by combining medical ozone with local block[J].Jilin Medical Journal, 2012, 33(11): 2245-2246.
[2]姜纪铭. 针刀治疗梨状肌综合征临床实践指南推荐方案文本的编写基础研究[D]. 北京: 北京中医药大学, 2013.
[3] 向娟,薛智慧,陈果,等.针刀治疗梨状肌综合征疗效的Meta分析[J].针灸临床杂志,2015(7):67-71.
[4]胡军祖, 佟磊, 王锐英,等. 相对安全区皮下松解术治疗臀肌挛缩症的疗效观察[J]. 中国矫形外科杂志, 2013, 21(3): 303-304.
[5]刘建民, 田文海, 田建刚,等. 新九针圆利针与芒针齐刺治疗梨状肌综合征疗效对照观察[J]. 中国针灸, 2013, 32(5): 422-425.
[6]魏美钢. 甲钴胺局部封闭治疗臀上皮神经卡压综合征疗效分析[J].中国实用神经疾病杂志, 2013, 16(7): 70-71.
[7]Wen Z Y, Zhang W B. Randomized parallel controlled study of extracorporeal shock wave treatment of piriformis syndrome[J]. Journal of Practical Traditional Chinese Internal Medicine, 2013, 27(5): 119-121.
[8]李常法, 张　杰, 王军茹. 排针攒刺松解疗法治疗臀上皮神经卡压综合征[J]. 中国针灸, 2012, 32(11): 984-988.
[9]侯孟君.针刀松解术结合拔罐治疗腰臀部软组织损伤的临床研究[D]. 广州: 广州中医药大学, 2013.
[10]隆腾飞, 张轩轩, 赵辉. 基于三维CT的臀上动脉解剖学研究[J]. 中国临床解剖学杂志,2013,31(4):402-406.
[11]杨剑峰. 臀上神经的应用解剖[D]. 延吉:延边大学,2011.
[12]Basarir K, Ozsoy M H, Erdemli B, et al. The safe distance for the superior gluteal nerve in direct lateral approach to the hip and its relation with the femoral length: a cadaver study[J]. Arch Orthop Trauma Surg, 2008, 128(7): 45-50.
[13]Miguel-Perez M, Ortiz-Sagrista J C, Lopez I, et al. How to avoid injuries of the superior gluteal nerve.[J] Hip Int, 2010, 20(7): 26-31.