髖關(guān)節(jié)外科脫位入路應(yīng)用解剖學(xué)測量
發(fā)布時間：2018-10-16 21:15
【摘要】：[目的]國外雖然有髖關(guān)節(jié)外科脫位入路應(yīng)用解剖學(xué)測量,但國內(nèi)尚無髖關(guān)節(jié)外科脫位入路應(yīng)用解剖學(xué)測量文獻(xiàn)。此次實驗為國內(nèi)首次髖關(guān)節(jié)應(yīng)用解剖學(xué)測量,一方面用以比較國內(nèi)外測量結(jié)果有無差異性,另一方面為髖關(guān)節(jié)外科脫位入路提供更為豐富的解剖學(xué)依據(jù)。[方法]選擇5具(10側(cè)髖部)新鮮尸體(男2,女3),4具新鮮尸體標(biāo)本經(jīng)頸總動脈注入稀釋肝素鈉后,待血管內(nèi)血栓充分溶解后,經(jīng)頸總動脈回抽至無法抽出液體。經(jīng)頸總動脈注入染色聚氯乙烯200-300ml,待聚氯乙烯充分聚合后,側(cè)臥位(方便解剖測量)按髖關(guān)節(jié)外科脫位入路行相關(guān)解剖學(xué)測量。觀測的內(nèi)容:(1)分別測量閉孔外肌、閉孔內(nèi)肌水平處,旋股內(nèi)側(cè)動脈距離轉(zhuǎn)子間嵴的距離,測量旋股內(nèi)側(cè)動脈距離小轉(zhuǎn)子之間的距離。(2)觀察并記錄旋股內(nèi)側(cè)動脈在股骨后方走形特點(diǎn),以及旋股內(nèi)側(cè)動脈深支進(jìn)入髖關(guān)節(jié)關(guān)節(jié)囊后在股骨頸上走形特點(diǎn)。(3)觀測旋股內(nèi)側(cè)動脈與臀下動脈分支所形成吻合血管支的特點(diǎn)。[結(jié)果](1)旋股內(nèi)側(cè)動脈距離小轉(zhuǎn)子平均距離17.20±2.25mm,旋股內(nèi)側(cè)動脈在閉孔外肌水平距離轉(zhuǎn)子間嵴平均距離6.60±1.43mm,旋股內(nèi)側(cè)動脈在閉孔內(nèi)肌水平距離轉(zhuǎn)子間嵴平均距離11.30±1.70mm。(2)在股骨頸后上方旋股內(nèi)側(cè)動脈深支進(jìn)入關(guān)節(jié)囊,股骨頸上終末血管支行走順時針范圍10:00至12:30。股骨頸下終末血管支行走順時針范圍5:00至6:30。股骨頸上終末血管支進(jìn)入滋養(yǎng)孔的位置距離關(guān)節(jié)邊緣:平均4.5mm(范圍3-10mm)。[結(jié)論](1)大轉(zhuǎn)子支是手術(shù)中確認(rèn)旋股內(nèi)側(cè)動脈深支重要的解剖學(xué)標(biāo)志。(2)股方肌上端、下[V肌下端的旋股內(nèi)側(cè)動脈即距離轉(zhuǎn)子間嵴6.60±1.43mm以內(nèi)及股骨頸后上方及稍前方屬危險區(qū)域。(3)臀下動脈分支與旋股內(nèi)側(cè)動脈深支所形成的吻合血管支對于股骨頭血液供應(yīng)至關(guān)重要。
[Abstract]:Objective: although there are applied anatomical measurement of dislocation approach in hip surgery abroad, there is no literature on applied anatomy measurement of surgical dislocation approach of hip joint in China. This experiment is the first applied anatomical measurement of hip joint in China. On the one hand, it is used to compare the results of measurement at home and abroad, and on the other hand, it provides more anatomical basis for the surgical dislocation approach of hip joint. [methods] five (10 hips) fresh cadavers (male 2, female 3) were selected. 4 fresh cadavers were injected with diluted heparin sodium via common carotid artery. The coloring PVC 200-300 ml was injected into the common carotid artery. After the PVC was fully polymerized, the lateral position (convenient anatomical measurement) was measured according to the surgical dislocation approach of the hip joint. The contents of the observations were as follows: (1) the distance between the medial circumflex femoral artery and the intertrochanteric crest was measured at the level of the external obturator muscle, the internal obturator muscle, and the medial circumflex femoral artery. The distance between medial circumflex femoral artery and small trochanter was measured. (2) observing and recording the shape of medial circumflex femoral artery in the posterior femur. And the shape of the deep branch of medial circumflex femoral artery on the femoral neck after entering into the hip joint capsule. (3) the characteristics of anastomosing branches of medial circumflex femoral artery and inferior gluteal artery were observed. [results] (1) the average distance between medial circumflex femoral artery and trochanter was 17.20 鹵2.25mm, the average distance between medial circumflex femoral artery and intertrochanteric crest was 6.60 鹵1.43mm, and that of medial circumflex femoral artery was 11.30 鹵1.70mm. The deep branch of the medial circumflex femoral artery above the neck of the bone enters the articular capsule. The terminal branch of the femoral neck runs clockwise from 10:00 to 12: 30. The subfemoral neck terminal branch runs clockwise from 5:00 to 6: 30. The superior femoral neck end vessel branch enters the trophoblastic foramen from the edge of the joint: average 4.5mm (range 3-10mm). [conclusion] (1) the greater trochanter branch is an important anatomic marker for the recognition of the deep branch of medial circumflex femoral artery. (2) the upper end of the quadratus femoris muscle. The medial circumflex femoral artery at the lower end of the V muscle is within 6.60 鹵1.43mm of the intertrochanteric crest and above and slightly anterior to the posterior femoral neck. (3) the anastomotic branch of the inferior gluteal artery and the deep branch of the medial femoral circumflex artery is essential to the blood supply of the femoral head.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4;R322
本文編號：2275645
[Abstract]:Objective: although there are applied anatomical measurement of dislocation approach in hip surgery abroad, there is no literature on applied anatomy measurement of surgical dislocation approach of hip joint in China. This experiment is the first applied anatomical measurement of hip joint in China. On the one hand, it is used to compare the results of measurement at home and abroad, and on the other hand, it provides more anatomical basis for the surgical dislocation approach of hip joint. [methods] five (10 hips) fresh cadavers (male 2, female 3) were selected. 4 fresh cadavers were injected with diluted heparin sodium via common carotid artery. The coloring PVC 200-300 ml was injected into the common carotid artery. After the PVC was fully polymerized, the lateral position (convenient anatomical measurement) was measured according to the surgical dislocation approach of the hip joint. The contents of the observations were as follows: (1) the distance between the medial circumflex femoral artery and the intertrochanteric crest was measured at the level of the external obturator muscle, the internal obturator muscle, and the medial circumflex femoral artery. The distance between medial circumflex femoral artery and small trochanter was measured. (2) observing and recording the shape of medial circumflex femoral artery in the posterior femur. And the shape of the deep branch of medial circumflex femoral artery on the femoral neck after entering into the hip joint capsule. (3) the characteristics of anastomosing branches of medial circumflex femoral artery and inferior gluteal artery were observed. [results] (1) the average distance between medial circumflex femoral artery and trochanter was 17.20 鹵2.25mm, the average distance between medial circumflex femoral artery and intertrochanteric crest was 6.60 鹵1.43mm, and that of medial circumflex femoral artery was 11.30 鹵1.70mm. The deep branch of the medial circumflex femoral artery above the neck of the bone enters the articular capsule. The terminal branch of the femoral neck runs clockwise from 10:00 to 12: 30. The subfemoral neck terminal branch runs clockwise from 5:00 to 6: 30. The superior femoral neck end vessel branch enters the trophoblastic foramen from the edge of the joint: average 4.5mm (range 3-10mm). [conclusion] (1) the greater trochanter branch is an important anatomic marker for the recognition of the deep branch of medial circumflex femoral artery. (2) the upper end of the quadratus femoris muscle. The medial circumflex femoral artery at the lower end of the V muscle is within 6.60 鹵1.43mm of the intertrochanteric crest and above and slightly anterior to the posterior femoral neck. (3) the anastomotic branch of the inferior gluteal artery and the deep branch of the medial femoral circumflex artery is essential to the blood supply of the femoral head.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4;R322
【參考文獻(xiàn)】
相關(guān)期刊論文 前2條
1 倘艷鋒;劉又文;朱英杰;李建明;李無陰;李啟義;賈宇東;;髖關(guān)節(jié)外科脫位入路治療股骨頭骨折[J];中國修復(fù)重建外科雜志;2015年11期
2 龔景海;顧國明;鮑欣彪;王小軍;丁富軍;;髖關(guān)節(jié)外科脫位入路手術(shù)治療股骨頭骨折的應(yīng)用體會[J];中國骨與關(guān)節(jié)損傷雜志;2015年06期
，本文編號：2275645
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