成人带蒂旋髂深动脉髂骨瓣的应用解剖研究  

Applied anatomy of iliac flap with pedicled deep iliac circumflex artery in adults

作　　者：余宏富 路云翔[1] 陈郁鲜[1] 彭优[1] 徐达政 李智勇[1] Yu Hongfu;Lu Yunxiang;Chen Yuxian;Peng You;Xu Dazheng;Li Zhiyong(Joint Surgery and Traumatic Orthopedics,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院关节外科创伤骨科,广州510630

出　　处：《新医学》2021年第9期692-696,共5页Journal of New Medicine

摘　　要：目的了解旋髂深动脉(DCIA)的起始、长度及与髂骨的关系,为带蒂DCIA髂骨瓣移植内固定治疗青壮年股骨颈骨折的临床应用提供解剖学依据。方法解剖6具(男3具、女3具)甲醛水溶液固定的成人躯体标本的12支DCIA,系统观测DCIA的起始、长度及与髂骨的关系。记录1例女性病例术中所测的髂骨瓣截骨大小、起始、长度及与髂骨的关系。结果6具成人躯体标本的12支DCIA均起源于髂外动脉,DCIA起始处外径为(2.26±0.21)mm,髂骨瓣血管蒂长为(5.89±0.33)cm,DCIA髂骨段长度为(1.34±0.29)cm,DCIA总长为(7.23±0.66)cm,DCIA与髂骨的垂直距离为(0.90±0.20)cm,男女及左右侧数据比较差异无统计学意义(P均>0.05)。1例女性病例术中测得截取髂骨大小为4.0 cm×0.8 cm,DCIA与髂前上棘的垂直距离为1.1 cm,远端DCIA距髂骨的垂直距离为1.0 cm,最后在距髂前上棘1.5 cm处与腹腔的血管相通,该处DCIA血管外径为0.6 mm,最终获得的带蒂髂骨瓣血管蒂长度为7.8 cm。结论通过DCIA可获取的血管蒂长度较长,血管外径理想,切取髂前上棘上方骨瓣不仅能使血管蒂达到合适长度,且能够保证髂骨瓣具有有效的血供。Objective To understand the relationship between the origin and length of deep circumflex iliac artery(DCIA)and with ilium,aiming to provide anatomical basis for the clinical application of internal fixation of pedicled DCIA flap in the treatment of femoral neck fracture in young adults.Methods Twelve DCIAs were dissected in 6 formalin-fixed adult cadavers(3 male and 3 female),and the origin and length of DCIA and the relationship with ilium were systematically observed.The size,origin and length of iliac flap and the relationship with ilium of 1 female case were measured and recorded intraoperatively.Results A total of 12 DCIAs were observed in 6 adult specimens,all of which originated from the external iliac artery.The external diameter of the origin of DCIA was(2.26±0.21)mm.The length of the iliac segment of the iliac flap was(5.89±0.33)cm.The length of the iliac segment was(1.34±0.29)cm.The total length of DCIA was(7.23±0.66)cm.The vertical distance between DCIA and ilium was(0.90±0.20)cm.No statistical significance was observed between the male and female cases or between the left and right sides(all P>0.05).The size of iliac bone of 1 female case was intraoperatively measured as 4.0 cm×0.8 cm.The vertical distance between DCIA and anterior superior iliac spine(ASIS)was 1.1 cm.The vertical distance between distal DCIA and ilium was 1.0 cm.Finally,it was communicated with the blood vessel of abdominal cavity at a distance of 1.5 cm from ASIS,where the external diameter of DCIA was 0.6 mm.Finally,the length of vascular pedicle of pedicled iliac flap was 7.8 cm.Conclusions A long vascular pedicle with an appropriate external vessel diameter can be obtained via DCIA.Resection of the bone flap above ASIS can not only make the vessel pedicle reach the appropriate length,but also ensure the effective blood supply of the iliac flap.

关 键 词：尸体解剖 股骨颈骨折 旋髂深动脉 髂骨瓣 

分 类 号：R687.3[医药卫生—骨科学]