旋股内侧动脉解剖学观测及在介入法治疗下肢动脉疾患的意义

Anatomical observation on the deep branch of medial femoral circumflex artery and its role in interventional therapy for lower-extremity arterial disease

目的:为利用旋股内侧动脉深支介入法治疗下肢动脉疾病提供解剖学依据。方法:股部正常经福尔马林固定动脉灌注红色乳胶成人下肢标本50侧。观测旋股内侧动脉及其深支的起源、起点外径、走行和分布。以两侧髂前上棘的连线作为X轴,经髂前上棘所作垂直线为Y轴。分别测量旋股内侧动脉及其深支起始处至X轴和Y轴的距离,以此定位旋股内侧动脉及其深支的起始端。结果:旋股内侧动脉起始处外径,男(4.75±0.94)mm,女(3.92±0.88)mm。其深支起点的外径,男(3.90±0.70)mm,女(3.43±0.69)mm。旋股内侧动脉起点距X轴的距离:男(10.21±1.16)cm,女(9.58±1.67)cm;与Y轴间距:男(5.66±1.02)cm,女(5.37±0.59)cm。旋股内侧动脉深支起点与X轴的间距:男(10.61±1.21)cm,女(9.92±1.42)cm;与Y轴之间的距离分别为(6.48±1.18)cm和(6.31±0.66)cm。上述指标中,旋股内侧动脉主干及其深支的外径具有性别差异(P<0.05)。结论:旋股内侧动脉深支可运用于介入治疗下肢动脉疾患。髂前上棘可作为标志定位旋股内侧动脉及其深支的起点。在操作中,要注意性别差异,并注意保护股血管。

Objective： To provide anatomical data for interventional therapy of lower-extremity arterial disease through the deep branch of medial femoral circumflex artery. Methods： The origins, origin diameter of the medical femoral circumflex artery and its deep branch were observed and measured aider dissection in 50 Chinese cadavers （male 25 sides, female 25 sides）. The localization of the origins of the medial femoral artery and its deep branch were defined according to distances to the horizontal （axis X） and vertical （axis Y） lines. The axis X was the line connected with bilateral anterior superior iliac spine. The vertical line through the anterior superior iliac spine was defined as axis Y. Results： The outer diameters of origin of the medial femoral circumflex artery and its deep branch were （4.75±0.94） mm and （3.90±0.70） mm in male and （3.92±0.88） mm and （3.43±0.69） mm in female. The distances of origin of the medial femoral circumflex artery and its deep branch to axis X were （10.21±1.16） cm and （10.61±1.21） cm in male, （9.58±1.67） cm and （9.92±1.42） cm in female. The distances of origin of the medial femoral circumflex artery and its deep branch to axis Y were （5.66±1.02） cm and （6.48±1.18） cm in male, （5.37±0.59） cm and （6.31±0.66） cm in female. No significant difference was found excluding to the outer diameters of origin of the medial femoral artery and its deep branch. Conclusions： The deep branch of medial femoral circumflex artery can be used as an inflow site for interventional therapy of lower extremity arterial diseases. The anterior superior iliac spine can be used as a marker to localize the origins of the medial femoral artery and its deep branch. Sex difference and protection of femoral vessels should be pay attention in the operation.