下肢缺血性疾病干细胞治疗相关的股内侧肌动脉应用解剖学

Artery anatomy of the vastus medialis directing stem cell implantation for ischemic disease of the lower extremity

目的：通过对营养股内侧肌的股动脉分支的观察和测量,为下肢缺血性疾病的干细胞治疗提供股内侧肌段的解剖学基础.方法：解剖观察20具成年人尸体（男12具,女8具）40侧下肢的营养股部肌肉的股动脉分支.测量营养股内侧肌各分支数量、位置、相邻分支间距离及各外径.结果：营养股内侧肌的股动脉分支相对较多,数量差异较小,分支间距相对较大,75％肢体出现2条营养股内侧肌的股动脉分支,22.5％肢体出现3条分支,仅2.5％肢体出现4条分支.其中70.8％男性肢体出现2条营养股内侧肌的股动脉分支,25.0％肢体出现3条分支,4.2％肢体出现4条分支;81.3％女性肢体出现2条营养股内侧肌的股动脉分支,18.7％肢体出现3条分支.该肌支的第1、第2、第3分支外径分别为（1.8±0.5）mm、（1.9±0.8）mm、（1.6±0.05）mm,第1分支距离腹股沟韧带中点（18.03±4.84）cm,各分支间距离分别为（6.4±2.7）cm、（5.4±2.4）cm.不同性别第3动脉分支的位置差异具有统计学意义.结论：股内侧肌具有恒定多血管（2～4条）营养,男女平均血管间距≥6.6 cm.本研究找到在位于第1分支与第2或第3分支距腹股沟韧带中点（18.03～24.44）cm或（18.03～29.81）cm的区域,此区域是下肢缺血性疾病干细胞治疗理想种植范围.

Objective：To explore the anatomical knowledge of artery supplying the vastus medialis with the aim of stem cell implantation to treat ischemic disease of the lower extremity.Methods：20 adult corpses （male 12,female 8） fixed with formalin were used to observe the branches from the femoral artery supplying the vastus medialis.Especially,the number,origin location,outer diameters of the arterial branches,and distances between the different branches were recorded.Results：Thirty vastus medialis samples occupying 75 ％ were supplied by two arterial branches,while the nine samples and one muscle were supplied by three and four arterial branches,which occupied 22.5％ and 2.5％,respectively.In detail,two-branches,three-branches and four-branches types were found in 70.8 ％,25 ％ and 4.2 ％ muscles in male cadavers,and in 81.3％,18.7％ and 0％ muscles in female cadavers,correspondingly.And,the outer diameters of the first branch,second branch and third branch were 1.8±0.5 mm,1.9±0.8 mm and 1.6±0.05 mm,respectively.The origin of the first branch was 18.03± 4.84 cm from the midpoint of the inguinal ligament.The distances between the different three branches were 6.4 ± 2.7 cm,5.4±2.4 cm.The statistical difference was undetectable in origin location of arterial branches defined as distance of origin to midpoint of the inguinal ligament regarding to different gender excluding that of the third branch.Conclusion：The vastus medialis was supplied by two to four arterial branches originated from the femoral artery.And,average distance between different arterial branches is longer than 6.6 cm.The regions from the 18.03 cm apart from the midpoint of the inguinal ligament to 24.44 cm or 29.81 cm could be used as feasible injection sides for stem cell implantation to treat ischemic disease of the lower extremity.