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女性泌尿生殖外科解剖

Author
Matthew D Barber, MD, MHS
Section Editor
Linda Brubaker, MD, FACOG
Deputy Editor
Sandy J Falk, MD, FACOG
Translators
胡燕, 主任医师，副教授

引言

妇科及泌尿科手术常采取经阴道或经会阴入路。进行盆腔手术要求术者全面掌握盆腔解剖知识以安全进入、最大程度地暴露术野、确保止血，以及避免损伤脏器、血管及神经。

本文将总结女性下生殖道及泌尿道的解剖，这些知识是盆骨外科医生经阴道或会阴入路进行手术时必须掌握的。本专题也将讨论目前对女性盆腔器官支持功能的理解，并重点介绍阴道、尿道和骨盆底的功能解剖及外科解剖。进行剖腹手术或腹腔镜的外科医生需要掌握的女性生殖道、下泌尿道及胃肠道解剖将单独讨论。 (参见“女性盆腔的外科解剖学”)

外科知识精要

在整篇文章中，临床上适用于女性盆腔手术的解剖学特症都采用缩进格式，并加以项目符号标识。

骨盆骨骼

出生时，构成盆骨的骨骼包括髂骨、坐骨、耻骨、骶骨和尾骨。16-18岁时，髂骨、坐骨和耻骨相融合形成髋骨。因此，成人的骨盆骨骼由左右髋骨、骶骨和尾骨构成(图 1和图片 1)。骨性骨盆是所有骨盆韧带和肌肉附着的坚实基础。

髂骨 — 髂骨位于骨盆最上方，其上部展开形成扁平的扇形“髂骨翼”，对下腹部起支撑作用，又称为假骨盆。髂骨内侧面有两个凹陷，其形成骨盆出口的外缘(骨盆下方开口)。上方较大的凹陷为坐骨大切迹(即骶骨、髂骨和坐骨棘的边缘)。

                                                    

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Literature review current through: 2017-06 . | This topic last updated: 2015-09-14.
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Topic Outline

GRAPHICS