摘要
目的:探讨闭孔血管和髂外血管在腹股沟区的分支,为减少髂腹股沟入路术中出血提供解剖学基础。方法:对25具新鲜中国成人尸体标本共50侧半骨盆进行解剖学研究,观测闭孔血管和髂外血管在腹股沟区的分支及其吻合支(CoronaMortis血管)的大小、出现率、吻合血管行径和吻合血管至耻骨联合的距离。结果:72%(36侧)耻骨上支表面至少存在1条血管吻合支,其中28%(14侧)存在2条或3条血管吻合支,24%(12侧)同时存在动脉吻合支和静脉吻合支。耻骨上支表面的血管吻合支平均直径2.6mm(2.0～4.2mm)。血管吻合支紧贴耻骨上支或髂耻隆起,几乎垂直地下行于髋臼窝壁或耻骨支后方,经闭膜管出盆腔,血管吻合支与耻骨联合的平均距离52mm(38～68mm)。在此区域手术以及髋臼或骨盆前环骨折极易损伤CoronaMortis血管。结论:闭孔血管和髂外血管的吻合支较粗,出现率高,位于耻骨上支表面。髂腹股沟手术入路应特别注意CoronaMortis血管的存在。
Objective ：To observe branches of obturator blood vessels and external iliac blood vessels at inguinal region, so as to provide anatomic basis for reducing hemorrhage in ilioinguinal approach. Methods： Twenty-five pelvis specimens of fresh native adult corpse with intact soft tissues （50 hemi-pelvises） were observed in the study. All vessels with diameter more than 2 mm, connecting with obturator system and external iliac systems,were identified and their courese were recorded. The distance from pubic symphysis to the vascular connections between the obturator and external ihac systems was measured. The incidence of vascular anastomosis were studied. Results：The dissections results showed 72 percent of cadaveric sides （36 sides in 50 hemi-pelvises） had at least one vessel communicating between the obturator system and external lilac or inferior epigastile systems on the superior pubic ramus. Among them, 28 percent （ 14 sides in 50 hemi-pelvises） had two or three vessels, and 24 percent（ 12 sides in 50 hemi-pelvises） contained both arterial and venous conduits. The average diameter of vessels was 2. 6 mm（2. 0 -4.2 mm）. The distance from pubic symphysis to the vascular connectious between the obturator and external ihac systems was 52 mm（38 -68 mm）. It coursed over the superior pubic ramus or iliopubic eminence vertically to enter the obturator foramen. It is easily damaged in the ilioinguihal approach as an anterior approach to the acetabulum and pelvis for the operative treatment of anterior wall acetabular and anterior column pelvic fractures. Conclusion： Vascular connections between the obturator system and external lilac or inferior epigastric systems locates over the superior pubic ramus at high incidence and is thicker in diameter. It courses over the superior pubic ramus vertically to enter the obturator foramen and exits the pelvis. Attention needs to be paid to corona morris vessels locating over the superior pubic ramus during the ilioinguinal approach as an anterior appro
出处
《中国骨伤》
CAS
2006年第6期355-357,共3页
China Journal of Orthopaedics and Traumatology
