耻骨后血管解剖特点及临床意义  

Anatomical characteristics of retropubic vessels and its clinical significance

作　　者：王子畅 王学虎[1] 赵渝[1] 宋伟 范高祥[1] WANG Zi-chang;WANG Xue-hu;ZHAO Yu;SONG Wei;FAN Gao-xiang(Department of Vascular Surgery,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院血管外科,重庆400016

出　　处：《局解手术学杂志》2023年第8期704-707,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：科卫联合医学科研项目(2019MSXM057)。

摘　　要：目的明确耻骨后血管的解剖特点、类型和死亡冠血管的发生率。方法回顾性分析我院126例行腹腔镜手术的腹股沟疝患者的临床资料,记录耻骨后区血管的解剖特点。结果126例患者共163侧血管,动脉型52侧(31.9%),静脉型89侧(54.6%),小血管丛型22侧(13.5%);走行主要为Ⅰ型(52.1%)、Ⅲ型(18.4%)和Ⅳ型(28.8%)。在37例双侧疝中,仅8例血管类型一致。动脉型在不同性别、疝类型中的分布差异无统计学意义(P>0.05),动脉型在右侧的发生率高于左侧(P<0.05)。静脉型在男性中的发生率高于女性(P<0.05),在斜疝中的发生率高于直疝、股疝(P<0.05),在左右两侧中的分布差异无统计学意义(P>0.05)。小血管丛型在男性中的发生率高于女性(P<0.05),在斜疝中的发生率高于直疝、股疝(P<0.05),在左侧的发生率高于右侧(P<0.05)。结论耻骨后区的血管形式多样,以静脉型血管为主,且死亡冠血管的发生率较高。动脉型主要为Ⅰ型,在不同性别与疝类型中的分布没有差别,右侧的动脉型血管出现概率高于左侧。静脉型以Ⅰ型和Ⅳ型为主,其与小血管丛型更容易在男性及斜疝患者中发生,临床应引起重视。Objective To determine the anatomical characteristics,types,and incidence of corona mortis in the retropubic vessels.Methods The clinical data of 126 patients with inguinal hernia who underwent laparoscopic surgery were retrospectively analyzed,and the anatomical characteristics of vessels in the retropubic region were recorded.Results Among the 126 patients,a total of 163 sides of vessels were analyzed,with 52 sides(31.9%)of arterial type,89 sides(54.6%)of venous type,and 22 sides(13.5%)of small vessel plexus type.The predominant classifications were typeⅠ(52.1%),typeⅢ(18.4%),and typeⅣ(28.8%).Among the 37 cases of bilateral hernia,only 8 cases had consistent vessel types.There was no statistically significant difference in the distribution of arterial type between different genders or hernia types(P>0.05),but the incidence of arterial type in the right side was higher than that in the left side(P<0.05)The incidence of venous type was higher in the males than that in the females(P<0.05),higher in the oblique hernias than that in the direct hernias or femoral hernias(P<0.05).There was no significant difference in the distribution between the left and right sides(P>0.05).The incidence of small vessel plexus type was higher in the males than that in the females(P<0.05),higher in the oblique hernias than that in the direct hernias or femoral hernias(P<0.05),and higher in the left side than that in the right side(P<0.05).Conclusion The vessels in the retropubic region display diverse forms,with the venous type vessels being predominant,and a relatively high incidence of corona mortis.TypeⅠis the main arterial type,with no differences in the distribution between different genders orhernia types,but with a higher incidence in the right side than in the left side.The typeⅠand typeⅣare the main venous type,and is more likely to occur in patients of males and oblique hernias with small vessel plexus type,which should be paid attention to clinics.

关 键 词：耻骨 死亡冠血管 静脉型 动脉型 出血 腹腔镜手术 

分 类 号：R602[医药卫生—外科学]