摘要
目的探讨猪股骨头支持带静脉的数量、分布、外径等解剖特点,以及吻合断裂之支持带静脉重建股骨头静脉回流的可行性。方法取35例新鲜猪股骨头标本,标本髋周血管无损伤。(1)取25例标本显微镜下寻找旋股内、外侧静脉及其主要出股骨头属支,注入明胶-硫酸钡溶液后,去除血管周围软组织,完成股骨头支持带静脉灌注标本的制备。在肉眼及显微镜下观察股骨头各组支持带静脉的走行、分布、数量,用显微标尺测量各组支持带静脉的外径。以钟表式刻度盘(钟表盘)对各组支持带静脉进行定位。(2)取另10例标本在股骨颈中段离断股骨颈制备股骨颈骨折模型,对骨折模型进行解剖复位克氏针内固定。根据股骨头支持带静脉灌注标本观察结果,选择外径最大之断裂的支持带静脉的远近端行端端吻合。吻合完成后,吻合血管内灌注明胶-硫酸钡溶液,观察吻合口的通畅情况及股骨头其他部位支持带静脉的充盈情况。结果(1)25例股骨头支持带静脉灌注标本显示:猪股骨头支持带静脉从滋养孔穿出后沿股骨颈走行在支持带下方,支持带静脉支数为1~7(14.2±2.6)支,根据支持带静脉在股骨颈上的分布位置分为前方组、后上方组、后方组及后下方组4组。以上4组支持带静脉支数依次为2~6(3.4±0.9)支、1~6(4.0±1.1)支、1~3(1.7±0.6)支、2~7(5.0±1.5)支,在钟表盘上的定位依次为2:20~4:30、11:10~1:40、8:50~11:00、6:30~8:20,支持带静脉的外径依次为0.25~1.40(0.69±0.18)mm,0.30~1.50(0.71±0.20)mm,0.20~1.10(0.60±0.15)mm,0.30~1.50(0.75±0.19)mm。(2)10例猪股骨颈骨折模型均顺利完成断裂支持带静脉端端吻合,吻合后血管灌注明胶-硫酸钡溶液均顺利通过吻合口,持续灌注后股骨头其他支持带静脉也有硫酸钡溶液充盈。结论猪股骨头支持带静脉的数量及位置相对恒定,后下组支持带静脉外径最大。股骨颈骨折后,吻合断裂的后�
Objective To explore the anatomic characteristics of the number,distribution,and diameter of retinacular veins of the femoral head in pigs and the feasibility of anastomosing fractured retinacular veins to reconstruct femoral head venous return.Methods A total of 35 fresh pig femoral head specimens were collected,and the perihip vessels were not injured.(1)The medial and lateral femoral circumflex veins and main branches of the femoral head were found under the microscope in 25 cases.After gelatin-barium sulfate solution was injected,the perivascular soft tissues were removed to complete the preparation of retinacular vein perfusion specimens of the femoral head.The traveling mode,distribution,and number of retinacular veins in each group of femoral head were observed by naked eye and microscopy,and the external diameter of retinacular veins in each group was measured by a microscale.A clockwork dial(clock dial)was used to locate the retinacular veins of each group.(2)Another 10 specimens were transected in the middle part of the femoral neck to prepare the femoral neck fracture model.Anatomical reduction and internal fixation of the fracture model were completed with a Kirschner wire.According to the observation results of femoral head retinacular vein perfusion,the proximal and distal ends with the widest external diameter were selected for end-to-end anastomosis.After anastomosis,gelatin-barium sulfate solution was perfused to observe the patency of anastomosis and the filling of retinacular veins in other parts of the femoral head.Results(1)The 25 cases of pig femoral head retinacular vein perfusion showed that the femoral head retinacular veins ran below the femoral neck retinacular after perforating through the nourishing foramen.The number of retinacular veins was 1-7(14.2±2.6).Based on the distribution position of retinacular veins in the femoral neck,the femoral head retinacular veins of the pig was divided into four groups:anterior,posterosuperior,posterior,and posteroinferior.The number of veins in th
作者
耿凯龙
唐林峰
张向南
王宏宇
刘澒洞
邓伟
汪丁松
侯瑞兴
Geng Kailong;Tang Linfeng;Zhang Xiangnan;Wang Hongyu;Liu Hongdong;Deng Wei;Wang Dingsong;Hou Ruixing(Department of Orthopedics,Suzhou Ruihua Orthopaedic Hospital,Suzhou 215104,China;Clinical College of Suzhou Medical College of Soochow University,Suzhou 215123,China;Clinical College of Yangzhou University Medical College,Suzhou 225009,China)
出处
《中华解剖与临床杂志》
2023年第7期480-485,共6页
Chinese Journal of Anatomy and Clinics
基金
江苏省研究生科研与实践创新计划(SJCX22_1515)
苏州市青年科技项目(KJXW2021081)。
关键词
猪
支持带静脉
股骨头坏死
股骨颈骨折
解剖学
Pig
Retinacular veins
Femoral head necrosis
Femoral neck fracture
Anatomy
