GenitofemoralNerve(InguinalCanal)Block
生殖股神经（腹股沟管）阻滞
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PhilipPeng,MBBS,FRCPC,RachaelSeib,MD,BerhardMoriggl,MD
作者
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Introduction?介绍
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Genitofemoralnerve,togetherwithiliohypogastricandilioinguinalnerves,areknownas‘bordernerves’because?thesenervessupplytheskin‘bordering’betweentheabdomenandthigh.Thenerves,becauseoftheircourseandlocation,areatriskofinjuryduringlowerabdominalsurgery(Pfannenstielincision,appendectomy,inguinalherniorrhaphy)orlaparoscopicsurgery(trocarinsertion).?
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生殖股神经，和髂腹下和髂腹股沟神经一起，被称为“边界神经”，因为这些神经支配腹部和大腿之间的“边界”皮肤。鉴于这些神经的走形和位置，在下腹部手术（Pfannenstiel?切口，阑尾切除术，腹股沟疝修补术）或腹腔镜胆囊手术（trocar的置入）期间可能有损伤的风险。
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Asaresult,patientsmaysufferfromchronicpost-surgicalpainduetonerveinjury.[1-2]Patientssufferingfrompostsurgicalneuropathypresentwithgroinpainthatmayextendtothescrotumorthetesticleinmen,thelabiamajorainwomen,andthemedialaspectofthigh.Accuratediagnosticblockadeofthesenerveshelpstoelucidatetheetiologyoftheclinicalproblem.
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由于这个原因，患者可能因为神经损伤遭受慢性的术后疼痛。遭受术后神经病变的患者呈现为腹股沟疼痛，在男性可能延伸到阴囊和睾丸，在女性延伸到到大阴唇，还有大腿的内侧。精确的诊断性阻滞这些神经帮助阐明临床问题的病因。
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Anatomy?解剖
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Thegenitofemoralnerveoriginatesfromthefirstandsecondlumbarnerveroots(Figure1).Itemergesontheanteriorsurfaceofthepsoasmuscleeitherasasingletrunkorasseparategenitalandfemoralbranches.[3]Thefemoralbranchpasseslaterallyovertheexternaliliacarteryandthenpenetratesthefascialatatoenterthefemoralsheath.Terminalbranchesprovidecutaneousinnervationtothefemoraltriangle.
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生殖股神经从腰1,2神经根发出（图1）。它出现于腰大肌的前表面可为一个单独的干或分为生殖支和股支。股支经过髂外动脉外侧，穿过阔筋膜进入股鞘。终末支提供股三角的皮肤支配。
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Thegenitalbranchalsocrossesinfrontoftheexternaliliacarterybutthenpassesthroughtheventralaspectoftheinternalringoftheinguinalcanal.Anatomicalstudiesshowthatthegenitalbranchrunsbetweenthecremasterandinternalspermaticfascia,incorporatingwiththecremastericfascia,orlyingoutsideofthespermaticcord.[4-6]Terminalsensorybranchesmayinnervatethescrotumandpossiblytheupper,inner,andmedialthigh.[5]
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生殖支同样越过髂外动脉的前方，然后穿过腹股沟管内环的腹侧。解剖学研究显示生殖支在提睾肌与精索内筋膜之间走形，包含在提睾肌筋膜里或位于精索的外侧。终末感觉支可能支配阴囊和大腿的上，内，中部。?
?生殖股神经（股支和生殖支）?髂腹下神经??髂腹股沟神经
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Figure1.Schematicdiagramshowingthecourseoftheilioinguinal,iliohypogastricandgenitofemoralnerves.GFN=genitofemoral?nerve.ReproducedwithpermissionfromUSRA(
