基于解剖学研究的三级命名法在旋股外侧动脉主要分支命名中的应用探讨

The nomenclature of the main branches of the lateral circumflex femoral artery by the three-stage nomenclature based on anatomical study

目的探讨三级命名法在旋股外侧动脉(LCFA)主要分支命名中应用的可行性及意义。方法解剖37具69侧成人防腐下肢标本,观察LCFA的起源以及其主要分支数目、口径、长度、走行分布等情况。使用三级命名法对主要分支进行命名并分析主要分支间关系。结果69侧LCFA起源于股深动脉64侧(92.8%)、股动脉5侧(7.2%)。按照三级法对69侧下肢标本的LCFA各主要分支进行命名:65侧(94.2%)出现斜向上走行的升支共65支,其起始处外径(1.17±0.42)mm,自发出位置至入肌长度(3.21±0.91)cm;65侧(94.2%)出现近乎水平走行的横支共65支,其起始处外径(1.00±0.51)mm,自发出位置至入肌长度(2.9±1.1)cm;66侧(95.7%)出现斜向下走行的斜支共78支,其中12侧(17.4%)为双斜支,其起始处外径(0.94±0.48)mm,自发出位置至入肌长度(4.6±2.4)cm;69侧(100.0%)出现近乎垂直走行的降支共72支,其中4侧(5.8%)为双降支,其起始处外径(1.40±0.68)mm,自发出位置入肌长度(11.1±4.6)cm。69侧中,采用一级命名法命名者44侧(63.8%)、二级命名17侧(24.6%)、三级命名8侧(11.6%)。结论LCFA主要分支发出位置及形态学变化较大,首次采用三级法可以准确命名各主要分支,可行性高,对股前外侧皮瓣血供解剖研究有较高的参考价值。

Objective To explore the feasibility and significance of the three-stage nomenclature in the naming of the main branches of the lateral circumflex femoral artery(LCFA).Methods The LCFA and its branches were dissected from the embalmed lower limbs specimens of 37 adult cadavers(69 sides)to observe the origin,number,diameter,length,and distribution of the main branches of the LCFA.The three-level naming method was used to name the main branches and analyze the relationship among the main branches.Results Among the 69 sides,LCFA originated from profunda femorisartery in 64 sides(92.8%)and femoral artery in 5 sides(7.2%).Among the branches,65 were ascending branches that ran obliquely upwards with 65 sides,the appearance rate of 94.2%(65/69),and the outer diameter at the beginning of(1.17±0.42)mm from the origin to the muscle.The length was(3.21±0.91)cm.A total of 65 horizontal branches ran almost horizontally with 65 sides,the appearance rate of 94.2%(65/69),and the outer diameter at the beginning of(1.00±0.51)mm.The muscle length was(2.9±1.1)cm.A total of 78 oblique branches ran obliquely downward with 66 sides,the occurrence rate of 95.7%(66/69),and the outer diameter at the beginning of(0.94±0.48)mm.The length into the muscle was(4.6±2.4)cm with 12 sides of the biaxial oblique branches on 69 sides.A total of 72 descending branches were nearly vertical with 69 sides,the appearance rate of 100.0%,the outer diameter at the beginning of(1.40±0.68)mm,and the length from the launch position to the muscle entry of(11.1±4.6)cm.A total of 69 sides of the middle and double descending branches had 4 sides.Among the 69 sides,44(63.8%),17(24.6%),and 8(11.6%)sides were named on the basis of the first-grade,the second-grade,and the third-grade naming methods,respectively.Conclusions The location and morphology of the main branches of the LCFA vary greatly.For the first time,the three-level method is used to name the main branches accurately.This method is highly feasible and has a high reference value for the anatomy of the blood supply of the anterolateral thigh flap.