腰动脉的应用解剖及临床意义.docVIP

腰动脉的应用解剖及临床意义 徐强，代远斌1,孙善全2，张树君1，孙英信1 (1重庆医科大学附属第一医院血管外科，重庆，400016 2重庆医科大学解剖学教研室，重庆400016) 摘 要 目的 系统研究腰动脉的局部解剖关系，明确腰动脉主要分支分布情况。方法 选用50例腰动脉完整无损的成年尸体，解剖并观察腰动脉及其动脉之间的走形、分布、外径、分支。结果 本组50例尸体标本中发现腰动脉全部起自腹主动脉后壁。腰动脉对称分布42例（84%），其中腰动脉为4对38例（76%），5对及以上4例（8%）；不对称分布8例（16%），其中一侧为3条，另一侧为4条。腰动脉分支主要为前支，后支及脊支。其中脊支Adamkiewicz动脉12例。腰段Adamkiewicz动脉左侧与右侧起源分布差异无统计意义（P=0.911）。结论 以上对腰动脉的观测结果，为临床有关腰椎及腹主动脉的手术、操作提供了较为系统、全面的动脉解剖学基础。 关键词 腰动脉；解剖；Adamkiewicz动脉；临床意义 Applied anatomy and Clinical significance of lumbar artery Xu Qiang，Dai Yuanbin，et al (1Department of Vascular Surgery，First Affiliated Hospital of Chongqing Medical University，Chongqing 400016; 2 Department of Anaomy，Chongqing Medical University,Chongqing 400016 ) Abstract Objective：Methods：arteries，anatomized and observed the shape and distribution of lumbar arteries and the diamete between them. Results：Lumbar arteries of the 50 samples of adult corpses all stemmed from abdominal aorta. There were 42 cases (84%) of lumbar artery symmetric distribution, among which38 cases (76%) of four pairs of waist artery, 4 cases (8%) of 5 pairs and above. while there were 8 cases (16%) of lumbar artery asymmetric distribution. The branches of lumbar artery were mainly the former，after and ridge team. There were12 cases of Adamkiewicz artery ridge teams .The origin and distribution of the left and right lumbar Adamkiewicz artery was statistically insignificant (P = 0.911).Conclusion: Data of this study based on applied anatomy provides systematic and detailed basis for operations on the abdominal aorta and the relevant lumbar surgery. Key words：lumbar artery；anatomy；Adamkiewicz artery ；clinical significance 随着介入技术、人工血管材料的进步，腹主动脉瘤治疗的开展愈加广泛，截瘫是腹主动脉重建术后一种常见的严重并发症，发生率在10%左右[1]。腰椎手术，特别是经皮穿刺椎间盘切吸术，术中对血管的损伤发生率亦较高【2-4】。本文通过比较腰动脉的走形分布口径，并进行统计学处理，为减少血管损伤及重建血管提供解剖学基础。 1 材料和方法 1.1 标本来源 重庆医科大学解剖教研室提供的成年尸体50具，其中男性尸体标本26具，男性尸体标本12具，局部标本12具，各标本腰段完整。 1.2 方法 在该50具经常规固定的尸体标本上按层次解剖出腰动脉及其它们的分支，然后以解剖学体位，观察其走行及分