低位腹主动脉外阻断的临床应用解剖学研究

Anatomic study for distal abdominal aorta blockage

目的:对腹主动脉下段及其主要分支的解剖关系进行观察,为低位腹主动脉外阻断提供解剖学理论依据。方法:对27具尸体标本进行解剖,解剖出腹主动脉下段的主要分支(肠系膜下动脉、第三、四腰动脉、骶正中动脉),测量分支间的距离及其与腹主动脉分叉处的距离,进行统计学处理。结果:肠系膜下动脉到主动脉分叉最低点距离为2.73～5.57cm,平均4.27±0.8cm。肠系膜下动脉到第三腰动脉的距离为-0.69～1.33cm,平均0.46±0.52cm。第三、四腰动脉间的距离为1.27～3.45cm,平均2.18±0.48cm。第四腰动脉到骶正中动脉的距离为0～2.42cm,平均1.09±0.62cm。骶正中动脉到腹主动脉分叉最低点的距离为0.02～1.50cm,平均0.53±0.37cm。第三、四腰动脉间的距离与第四腰横动脉至骶正中动脉的距离比较,经配对设计两样本均数t检验,有显著性差异(P<0.01);二者中点距离腹主动脉分叉处2.71±0.62cm。结论:左下腹膜外入路至腹主动脉距离近,为最佳途径;第三、四腰动脉间的距离最宽,二者之中点距腹主动脉分叉处距离合适,是外阻断的最佳部位。

Objective：To investigate the regional anatomy of the distal abdominal aorta and provide the rational for distal abdominal aorta blockage.Method：27 specimen of human being were used and the main branches of the distal abdominal aorta locally were dissected.The distance between branches and the distance between branches and peripheral important organs were investigated and analyzed statistically.Result：The distance between the inferior mesenteric artery and the distal point of the abdominal aorta bifurcation and between the inferior mesenteric artery and the third lumbar artery was 2.73-5.57cm（average,4.27±0.8cm） and 0.69-1.33cm（average,0.46±0.52cm） respectively.The distance between the third and fourth lumbar arteries and between the fourth lumbar artery and medial sacral artery was 1.27-3.45cm（average,2.18±0.48cm） and 0-2.42cm（average,1.09±0.62cm） respectively.The distance between the medial sacral artery and the distal point of the bifurcation of the abdominal aorta was 0.02-1.50cm（average,0.53±0.37cm）.The distance between the third and the fourth lumbar arteries and that between the fourth lumbar artery and the median sacral artery was significantly different（P0.01）.The midpoint of their interval was 2.71±0.62cm away from abdominal aorta bifurcation.Conclusion：The abdominal aorta between the third and fourth transverse lumbar arteries is the widest and midpoint of their interval to abdominal aorta bifurcation is optimal,which is suitable for distal abdominal aorta blockage.