超声下股静脉与股动脉间解剖关系及其影响因素的研究

Anatomical observation of femoral vein to femoral artery and influence factors on its relation:an ultrasonic study

目的采用超声技术探讨左右侧、年龄及性别等因素对股静脉与股动脉间解剖关系的影响。方法随机选择成年患者275例,超声探头于短轴方向垂直接触腹股沟韧带中点下方2 cm处探测股静脉位于股动脉的解剖方位关系,描述为:内上、内侧、内下、外下、外侧、外上这六种方位关系。结果左右侧股静脉均主要位于股动脉的内下方(左57.45%,右66.18%),其次位于内侧(左37.09%,右28.00%),少数位于外下方(左4.36%,右4.36%),极少数位于外侧(左0.36%,右1.09%)及内上方(左0.73%,右0.36%);与左侧相比,右侧股静脉位于股动脉内侧的概率显著减少(P<0.05),位于股动脉内下方的概率显著增加(P<0.05)。与股静脉位于股动脉内侧患者年龄(44.78±10.28)岁比较,股静脉位于股动脉内下方患者的年龄(50.74±9.92)岁显著增加(P<0.05),股静脉位于股动脉外下方患者年龄(53.00±11.60)岁显著增加(P<0.05)。与男性相比,女性患者的股静脉位于股动脉内下方的概率显著增加(男39.71%,女60.29%)(P<0.05)。结论股动脉和股静脉之间的解剖关系变异较大,临床上对于不同患者行股静脉穿刺置管时要充分考虑到患者左右侧、年龄及性别因素的差异,选择合适的穿刺点及穿刺方向可显著提高穿刺成功率及减少并发症。

Objective To observe the anatomic relationship of femoral vein （FV） to femoral artery （FA）, and assess the effects of age, gender and side on these anatomical structures. Methods A total of 275 adult patients were enrolled in this observation. The FV and FA were investigated at 2 cm distal to the inguinal ligament by portable uhrasonography. Results A posteromedial location of the FV was the most common configuration observed on both sides （left 57.45%, right 66.18%） followed by the medial （left 37.09%, right 28.00%） and posterolateral （4.36% both side） locations. A few FV was located at lateral （left 0. 36%, right 1. 09%） and anteromedial （left 0. 73%, right 0.36%）to the FA. Compared with left side, right FV at medial location of the FA was significantly decreased （P〈0.05）, and at posteromedial location of the FA was significantly increased （P〈0.05）. Subjects with a posteromedial located FV （50.74±9.92） yrs were older than those with a medial （44.78±10, 28） yrs configuration （P〈0.05）, and subjects with a posterolateral located FV （53.00±11.60） yrs were older than those with a medial configuration （P 〈0. 05）. Compared with male, the posteromedial located FV on female was significantly increased （male 39.71%, female 60.29%, P〈0.05）. Conclusion The following factors are important for dertamine the FV anatomy relationship： age, gender and left-right side effect. It is very important for the operator choose appropriate puncture point and puncture direction to potentially reduce the chance of laceration of the FA and avoid placement of a large catheter within a critical artery.