摘要
目的对成人腰骶段脊柱前方重要血管进行解剖学研究,为腰骶段脊柱前路手术及内固定器械的研制奠定解剖基础。方法对80具成人尸体标本腰骶段脊柱前方重要血管的走行、分布进行大体观察并对部分血管指标进行解剖测量,将实验结果与文献回顾相关研究进行对比分析。结果腹主动脉位于脊柱左前方,下腔静脉位于脊柱右前方。左、右髂总动脉均在骶髂关节水平处分为髂内、髂外动脉。骶正中动脉走行及分布形式固定,而骶正中静脉变异较大。男性腹主动脉末端血管壁厚度为(1. 72±0. 17) mm,女性为(1. 52±0. 24) mm,差异无统计学意义(P> 0. 05);女性腹主动脉分叉角为(66. 4±2. 3)°,男性腹主动脉分叉角为(58. 9±4. 4)°,差异有统计学意义(P <0. 05)。男性左、右髂总动脉长度分别为(57. 6±4. 7) mm、(50. 1±5. 0) mm,女性分别为(43. 7±6. 1) mm、(37. 3±6. 3) mm,差异有统计学意义(P <0. 05)。男性下腔静脉汇合角为(60. 7±4. 8)°,女性下腔静脉汇合角为(66. 7±4. 8)°,差异具有统计学意义(P <0. 05)。男性左、右髂总静脉长度分别为(59. 4±3. 9) mm、(48. 7±3. 3) mm,女性左、右髂总静脉长度分别为(52. 8±6. 4) mm、(46. 6±3. 0) mm。结论尽管腰骶段脊柱前方血管众多,解剖复杂,但是存在一定的解剖规律,熟悉重要血管的解剖特点是提高腰骶段脊柱前路手术安全性的关键。
Objective To study the anatomy of important blood vessels in the front of the lumbosacral spine of healthy adults and lay anatomical foundation for the development of internal fixation devices and anterior approach surgery.Methods The distributions of important blood vessels in front of the lumbosacral spine from 80 healthy adults were observed and part of the vascular indexes were measured.The experimental results were compared with the results of the related literature reviewed.Results The abdominal aorta was located in the left-front of the spine,and the inferior vena cava lied right in front of the spine.Both the right and left common iliac arteries were divided into the internal iliac and external iliac arteries in the sacroiliac joint.The distributions of sacral median artery were relatively fixed while that of the sacral median venous had a larger variation.The thickness of the vascular wall at the end of the male abdominal aorta was(1.72±0.17)mm,and the female was(1.52±0.24)mm,there was no statistical difference(P >0.05).Abdominal aortic bifurcation angle for women was(66.4±2.3)°,abdominal aortic bifurcation angle for men was(58.9±4.4)°,there was statistically difference(P<0.05).The length of the left and right common iliac arteries were(57.6±4.7)mm and(50.1±5.0)mm in male,and those of the female were(43.7±6.1)mm and(37.3±6.3)mm respectively,and there was a statistical difference(P<0.05).The converging angle of inferior vena cava in male was(60.7±4.8)°and that in female was(66.7±4.8)°,which had a statistical difference(P<0.05).The length of the left and right common iliac vein in male was(59.4±3.9)mm and(48.7±3.3)mm while that of the female was(52.8±6.4)mm and(46.6±3.0)mm.Conclusion Although the anatomy of blood vessels in front of the lumbosacral spine is complex,there is some anatomic regularity.Mastering anatomical features of the important vascular is the key to improve the security of the anterior approach surgery in lumbosacral spine.
作者
韩华
韩佳栩
项燕
计胜峰
张峰昌
马延兵
杨寅
HAN Hua;HAN Jia-xu;XIANG Yan;JI Sheng-feng;ZHANG Feng-chang;MA Yan-bing;YANG Yin(Department of Human Anatomy and Histology Embryology,Health Science Center,Xi'an Jiaotong University,Xi'an Shaanxi 710061,China;Department of Medicine,Xi'an Jiaotong University,Xi'an Shaanxi 710061,China;Department of Internal Medicine,Xi'an Huashan Central Hospital,Xi'an Shaanxi 710043,China;Department of Orthopedics,Xi'an Central Hospital,Xi'an Shaanxi 710003,China)
出处
《局解手术学杂志》
2019年第2期91-95,共5页
Journal of Regional Anatomy and Operative Surgery
关键词
腰骶段脊柱
脊柱前路手术
血管
解剖
内固定
腹主动脉
髂内动脉
髂外动脉
lumbosacral spine
spinal anterior approach surgery
blood vessels
anatomy
internal fixation
aorta abdominalis
internal iliac artery
external iliac artery
