股动脉穿刺定位方法的优化研究  

Optimization of the location technique for puncturing site of common femoral artery

作　　者：曹莉明[1] 王杰[1] 施海彬[1] 周卫忠[1] 夏金国[1] 周春高[1] 

机构地区：[1]南京医科大学第一附属医院介入放射科,南京210029

出　　处：《介入放射学杂志》2013年第5期409-412,共4页Journal of Interventional Radiology

基　　金：江苏省高校优势学科建设工程资助项目(JX10231801)

摘　　要：目的通过分析股动脉与股骨头关系确定股动脉穿刺理想位置。方法对114例行介入诊疗患者经皮股动脉穿刺术后行穿刺侧髂动脉造影,分别采用3种不同股动脉穿刺定位分区方法对患者资料进行测量、比较和分析,并作进一步统计处理,以确定三者间差异有无统计学意义。新建议法:将髂前上棘与耻骨联合连线作为腹股沟韧带的虚拟体内标志,股动脉分叉处设为穿刺下限点。以股骨头上、下缘及中点平面为参照,由上向下将股骨头均分为A、B、C、D 4个区。对照法1是将股骨头从上到下分为A、B、C、D 4个区。对照法2是将股骨头分为5区。结果 114例患者3种不同分区方法穿刺下限点位置如下:新建议法A、B、C、D 4区分别0%、1.75%、7.89%、90.35%。对照法1分别为0%、2.63%、85.09%和12.28%。对照法2分别为0%、0.88%、1.75%、85.96%和11.4%。统计分析显示,差异有统计学意义(P<0.05)。结论新建议股骨头分区方法能够直观地反映股动脉分叉与股骨头及腹股沟韧带间关系,分析发现血管穿刺点位于新建议法股骨A^C平面间的股动脉段穿刺成功率较高,且安全、可靠。Objective To determine the optimal puncturing site of the common femoral artery by analyzing the anatomical relationship between the femoral artery and femoral head. Methods A total of 114 patients, who received interventional therapy and postoperative femoral angiography by percutaneous femoral artery puncture, were enrolled in this study. Three different location methods for determining femoral artery puncturing site were used to make the relevant measurements on the patient＇s angiograms. The results were statistically analyzed and compared between each other method. The new method proposed by the authors was as follows. Take the line between the anterior superior iliac spine and symphysis pubis as the internal landmark, the origin part of the femoral artery as the superior puncturing margin, and the bifurcation of femoral artery as the inferior puncturing border. The femoral head was divided into four zones （A, B, C and D） by its superior, inferior border and midpoint level. Control method No.l： the femoral head was divided, from top to bottom, into four zones （A, B, C and D）. Control method No.2： the femoral head was divided into five zones according to Huggins＇ method. Results The new method proposed by the authors showed that the percentage of femoral artery bifurcation location in the area of A, B, C and D was 0%, 1.75%, 7.89% and 90.35% respectively. In the control method No.l, the percentage of femoral artery bifurcation location in the area of A, B, C and D was 0%, 2.63%, 85.09% and 12.28% respectively. In the control method No.2, the percentage of femoral artery bifurcation location in the area of A, B, C, D and E was 0%, 0.88%, 1.75%, 85.96% and 11.4% respectively. The difference in the femoral artery bifurcation location wasstatistically significant among the three methods （P 〈 0.05）. Conclusion The proposed method is safe and effective, it can directly reflect the anatomical relationship between the femoral artery bifurcation and femoral head as well as inguinal ligament.The su

关 键 词：股动脉 穿刺点 优化 股骨头 

分 类 号：R543.5[医药卫生—心血管疾病]