儿童臀大肌下部肌瓣转位重建肛门外括约肌的应用解剖

目的:探讨儿童臀大肌下部肌瓣的神经及血供,为临床外括约肌重建术提供解剖学依据.方法:对29具儿童尸体的臀大肌进行解剖,观察肌瓣的神经及血管的来源数目、走行并测量相关的数据.结果:36侧肌瓣蒂的血管神经可得到保证(62.07%);7侧仅见动脉供应支或神经丛;5侧未发现较大的血管及神经进入;10侧臀下神经血管束受损.神经与血管在肌瓣蒂上的分布尚不能认为有差异(P＞0.05).结论:臀大肌下部肌瓣可以用作转位重建肛门外括约肌.

Applied Anatomy of Gluteal Myoplasty for Sphincter Replacement in Children

Objective:To explore the innervating nerves and supplying vessels of the transposed flaps below gluteus maximus muscle(GMM) in children and provide evidences for clinical procedure of the external anal sphincter reconstruction.Methods:The nerves as well as vessels in the pedicled flaps and their relevant data were observed and measured on buttocks of 29 children's cadavers.Results:The nerves and vessels in 36 pedicled flaps below their GMM could be assured,and one or another could be found in 7 flaps;neither was found in 5 flaps.Both nerve and vessel were damaged in 10 flaps.We could not infer that there was obviously different distributions of nerves and vessels in the pedicled flaps(P>0.05).Conclusion:The pedicled flaps below the GMM could be transposed to reconstruct the external anal sphincter.