体外腹主动脉末端施压控制骨盆骨折大出血的应用解剖

Applied anatomy of hematorrhea control in fracture of pelvis by abdominal artery terminal oppression in vitro

目的为体外腹主动脉末端加压控制骨盆骨折大出血提供应用解剖学基础。方法14例尸体标本,以第5腰椎上缘水平为基点,观测:①脐中点与腰椎体及腹主动脉端的位置关系;②腹主动脉末端与第5腰椎椎体的关系。③腹主动脉、下腔静脉与腰椎的位置关系。结果腹主动脉远段位于脊柱椎体前,以平L4椎体和L5椎体上部动脉血管段较为居中。腹主动脉末端分杈平面在基点以上22mm、以下15mm之间。脐中点在基点以上4.0cm、以下2.8cm范围内。结论可以脐为标志点定位腹主动脉末端对腹主动脉远端实施体外压迫,阻断血流或降低远端血压,达到紧急止血目的。

Objective To supply applied anatomy basis for hematorrhea control in fracture of pelvis by abdominal artery terminal oppression in vitro.Methods 14 cadaver specimens,8 male and 6 female,were observed.Taking the superior border of L5 as the basic point,indexes as follows were measured：1.The relationship between cleft hilum and the distal end of abdominal artery or lumbar vertebrae body;2.The position of the initial point of the inferior mesenteric plexus.3.The relationship between the vertic tracks of abdominal artery,lumbar vertebrae,and inferior vena cava.Results The abdominal artery terminal located between 22 mm above and 15 mm below the superior border of L5.The marker for abdominal artery terminal oppression in vitro,according to the relationship between the body surface projection of cleft hilum and abdominal artery terminal lumbar vertebrae,roughly overlapped the human median line.Conclusions According to the anatomy basis,cleft hilum can be regard as the marker for abdominal artery terminal oppression in vitro for hematorrhea control in fracture of pelvis.