股动脉分叉解剖位置的造影评价  

Angiographic evaluation of femoral artery bifurcation

作　　者：刘百球[1] 聂绍平[1] 贾长琪[1] 张崟[1] 吕强[1] 刘新民[1] 吴佳慧[1] 乔岩[1] 李军[1] 罗太阳[1] 董建增[1] 刘小慧[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,100029

出　　处：《中国介入心脏病学杂志》2010年第6期303-305,共3页Chinese Journal of Interventional Cardiology

基　　金：国家重点基础研究发展规划项目(973计划)基金资助(2003CB517103)

摘　　要：目的以股骨头和耻骨联合为参照,对股总动脉和股动脉分叉解剖位置进行造影评价,为介入诊疗股总动脉穿刺以及止血装置的应用提供解剖依据。方法对822例经股动脉行冠状动脉造影和/或血管成形术并拟使用血管闭合装置的患者,术后常规行穿刺侧髂动脉造影。以股骨头和耻骨联合为参照,造影下在股骨头上缘和耻骨联合中点之间连线,再沿股骨头下缘、上下缘的中点作两条平行线,由上到下将腹股沟分为A、B1、B2和C4个区,对股总动脉和股动脉分叉解剖位置进行造影评价。结果入选患者平均年龄(60±10)岁,其中男性占64.2%(528/822),汉族占97.7%(801/822)。股动脉分叉位于A、B1、B2、C区分别占0.2%(2/822)、4.6%(38/822)、43.1%(354/822)和52.1%(428/822),分叉位于股骨头中点以下(B2和C区)占95.2%。当穿刺点位于B区、B1区、B2区和C区时,股总动脉穿刺率分别为83.9%(668/796)、91.6%(271/296)、79.4%(397/500)和40%(8/20)。结论我们提出的腹股沟区血管分区新方法简单可靠,能更好地反映股动脉与腹股沟韧带的关系。造影分析发现,股动脉分叉多位于股骨头中点以下,血管穿刺在股骨头上下缘之间,尤其在股骨头上缘和中点之间,穿刺股总动脉的概率最高。Objective To study the variation in the site of femoral artery bifurcation relying on the femoral head and the pulic symphysis. Methods We retrospectively enrolled 822 consecutive patients undergoing cardiac catheterizations via femoral artery and femoral angiograms were taken in all patients who had used vascular closure devices. Taking the femoral head and the midpoint of pubic symphysis as landmarks,the midpoint,inferior and superior margin of the femoral head were used as borderlines to divide the inguinal region into four zones （A,B1,B2 and C）. The site of femoral artery bifurcation and common femoral artery （CFA） were evaluated on femoral angiogram in terms of these four zones.Results The percentage of femoral artery bifurcations locating in the area of A,B1,B2 and C was 0.2%（2/822）,4.6%（38/822）,43.1%（354/822） and 52.1%（428/822）,respectively. When arterial puncture located on zone B,B1,B2 and C,CFA cannulation occurred in 83.9%（668/796）,91.6%（271/296）,79.4%（397/500） and 40%（8/20）,respectively.Conclusion By introducing a reliable method for inguinal vascular zone division,the majority of femoral artery bifurcations were found to be located below the midpoint of femoral head. It is an effective measure to puncture the common femoral artery between the superior and inferior border of the femoral head,especially between the superior border and the midpoint of the femoral head.

关 键 词：股动脉 穿刺术 主动脉造影术 

分 类 号：R541.4[医药卫生—心血管疾病]