髂腰动脉蒂髂骨组织瓣的应用解剖

摘要

Objective To provide anatomical basis for elevating iliac tissue flap pedicled on the iliolumbar artery.Methods The course,number,outer diameter and distribution of iliolumbar artery were observed on 13 human cadavers.Results All the iliolumbar artery originated from the internal iliac artery.The iliolumbar artery gave off 2 branches (iliacus branch and lumbar branch) when passing between the obturator nerve and the lumbosacral trunk,posteriorly to the psoas major.The mean distance between origin of the iliolumbar artery and bifurcation point to iliacus and lumbar branches was 7.1 (7.1 ± 0.5) cm.The iliacus branch divided into two branches:one artery curved forward and anastomosed with the iliacus branch of deep circumflex iliac artery; the other artery supplied the tissue around the posterior superior iliac spine.The lumbar branch supplied the psoas major and the quadratus lumborum.Conclusion The iliolumbar artery and the iliacus branch is one of the most constant and reliable vessels supplying the iliac bone,and can be used as the pedicle of free or pedicled iliac tissue flaps.%目的 为髂腰动脉蒂髂骨组织瓣的切取提供解剖学依据. 方法 在13具成人尸体标本上,对髂腰动脉的走行、数量、管径以及分布情况进行解剖学研究. 结果 髂腰动脉均发自髂内动脉,发出后经腰大肌深层、闭孔神经和腰骶丛之间分为髂骨支和腰支.从髂腰动脉起点到分出髂骨支和腰支的分叉点的距离为7.1(7.1±0.5) cm.髂骨支在髂骨壁内发出2个分支,1支沿髂骨内侧壁向上、向髂前上棘走行,在髂骨壁中段与旋髂深动脉的髂骨支相吻合;另1支向上营养髂后上棘附近组织.腰支发出后向上走行营养腰大肌和腰方肌. 结论 髂腰动脉的髂骨支是营养髂骨的恒定、可靠的血管,可作为独立的营养血管蒂设计成游离或带蒂髂骨组织瓣.