股动脉走行与股骨头解剖关系及其影响因素在介入诊疗中的应用

Anatomical Relationship of Femoral Artery Courser and Femoral Head and Their Influence Factors in Application of Interventional Treatment

目的通过数字减影血管造影(DSA)技术分析股动脉走行与股骨头解剖位置关系,并探讨影响两者关系的相关因素。方法对219例经皮股动脉穿刺行介入诊疗患者术后常规行穿刺侧髂动脉造影,以股动脉长轴为参照,于股骨头中点及左右四分之一处做三条平行线,由内向外将股骨头分为A、B、C、D四个区,造影评价股动脉走形与股骨头之间关系。采用单因素分析两者之间关系与患者年龄、性别、身高、体表面积、高血压、糖尿病等的相关性。结果股动脉走形位于A、B、C、D四区分别为75.34%(165/219)、21.92%(48/219)、2.74%(6/219)、0。结论股动脉走行与股骨头解剖位置关系主要集中于股骨头内侧1/4部分,对于不同患者行股动脉穿刺时要考虑其年龄、性别及体重的差异,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局部血管并发症发生。

Objective To analyze anatomical relationship of femoral head courser and femoral artery by using digital subtraction angiography(DSA) and to investigate factors affecting their relationship. Methods Latero-iliac artery angiogram was performed routinely for 219 patients with interventional therapy by percutaneous femoral artery puncture. Long axis of femoral artery was used as the landmark, and three parallel lines were performed at the midpoint, quarter points of left and right margins of femoral head, and then femoral head was divided into four zones(A, B, C and D) from internal to external. Anatomic relationship of femoral artery course and femoral head was evaluated by angiography, and the correlations with age, gender, body height, body surface area, hypertension, diabetes mellitus and so on were analyzed by univariate analysis. Results Femoral artery course located in the area of A, B, C and D were 75.34%(165/219), 21.92%(48/219), 2.74%(6/219) and 0%(0/292) respectively. Conclusion Anatomical relationship of femoral head courser and femoral artery mainly focuses on quarter inside area of femoral head. Femoral artery puncture for different patients should thoroughly consider differences in age, gender and body mass. Appropriate puncture site and direction may effectively improve success rate of femoral artery puncture and reduce incidence rate of local blood vessel complications.