腋动脉分支类型的解剖学研究及意义

Variations in branching pattern of the axillary artery:an anatomical study of 90 specimens

目的对腋动脉分支形成的动脉干进行分型,为血管造影、外科干预提供解剖学基础。方法 90例(左侧47例,右侧43例)经10%福尔马林溶液灌注固定的人体上肢标本,解剖腋动脉各段分支及其形成的动脉干;采用游标卡尺,测量各段分支起点管径。结果①经典型腋动脉46例(51.1%),即各段分支均直接从腋动脉分出,未形成动脉干;②肩胛下-旋肱后动脉干28例(31.1%),此干最终分支为旋肩胛动脉、胸背动脉、旋肱后动脉;③有胸外侧动脉参与形成的动脉干10例(11.1%),分别有胸外侧-肩胛下动脉干、胸外侧-胸背动脉干及胸外侧-胸肩峰动脉干;④多分支型(≥4)动脉干6例(6.7%),根据其分支是否含有肱动脉的分支,进一步分为腋-胸动脉干及腋-肱动脉干;⑤右侧胸肩峰动脉起点管径显著高于左侧(P=0.015,t=-2.542)。结论对腋动脉分支所形成的动脉干尝试进行解剖学类型划分,是对既往研究的补充。在腋动脉造影时,有助于识别其变异,减少误诊;掌握这些动脉干的解剖学特征,对于腋血管损伤的外科治疗也具有积极意义。

Objective To evaluate the branching pattern of the axillary in human cadavers.Methods Ninety upper limbs(47 left sides,43 right sides)were perfused with 10%formalin solution.The limbs were dissected remaining continuity with the aterial trunks.Exposure of the axillary artery and its branches were achieved following classical incisions and procedures.The branching pattern of the axillary artery was studied under the following headings:origin of all branches,their courses and variations if present,and photographs were taken for recording.Results The classical type were observed in 51.1%cases,with all the branches originating from the axillary artery directly;Subscapular-circumflex humeral trunk(31.1%),which terminated as the circumflex scapular artery,thoracodorsal artery and posterior circumflex humeral artery.Common trunks associated with the lateral thoracic artery(11.1%):the lateral thoracic-acromial trunk,the lateral thoracicdorsal trunk and the lateral thoracic-subscapular trunk.Arterial trunks with mutiple branches(6.7%),which was divided into thoraco-axillary trunk and thoraco-humeral trunk if the profunda brachii artery involved.Compared with the left side,the diameter of the thoracoacromial artery was larger in the right side(P=0.015,t=-2.542).Conclusion The anatomical knowledge of the axillary region is of crucial importance for radiologists and vascular surgeons,particularly in cases involving traumatic injuries.