腰动、静脉在脊柱前路手术中的应用解剖学研究

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目的:对腰动静脉的位置分布及变异进行描述和统计分析,以提高腰骶段脊柱手术手术的安全性和有效性。方法:对30具尸体标本进行解剖学研究,主要观察(1)腰动静脉的数量与缺失,各节段腰动静脉发出点位置的定性描述,(2)腰动静脉左右共干与上下共干的概率以及腰动静脉的其他变异。结果:腰动脉的数量以及位置相对固定,有5对腰动脉的一共有5例,腰动脉发出点的位置也不是完全与腰椎对应。腰动脉左右共干的占9.6%,未见上下共干。动脉中仅有65.3%的动脉有静脉伴行。腰静脉的数量变异非常大,最少一侧仅有1支腰静脉,最多有5支,最常见的情况是3支,占36.7%。腰静脉的位置变异也较大,与椎体没有特别的规律。腰静脉的左右共干的概率要大于动脉,为38.5%,而上下共干也是腰静脉的独有的现象,总共有26支,占总数的12.5%。另外,腰静脉的其他变异多见。结论:当脊柱手术选择腹主动脉左侧入路或者腹主动脉下腔静脉之间入路时,腰动脉和腰静脉的解剖特点尤为重要。动脉的位置相对较恒定,而静脉则变异较大,缺失常见,左右共干,上下共干,静脉之间的大的交通支常见,与腰椎的对应性不如动脉,且其与动脉并非严格伴行,这些原因都造成了静脉容易损伤的原因,在手术中应该特别注意。 Objective: To describe and analyze the distribution and variation of lumbar artery and vein in order to improve the safety and effectiveness of lumbosacral spine surgery. Methods: Anatomical study of 30 cadaver specimens was performed. The main observations were as follows: (1) the number and absence of lumbar and veins, the qualitative description of the location of the lumbar and venous arteries in each segment, (2) Probability of dry and other variations of lumbar and venous arteries. Results: The number and location of lumbar arteries were relatively fixed. There were 5 cases of lumbar arteries in 5 cases. The position of lumbar arteries issued was not completely corresponding to lumbar vertebra. Left and right lumbar artery accounted for about 9.6% of the total, not seen from top to bottom total dry. Only 65.3% of the arteries in the artery had vena cava accompanying. Variations in the number of lumbar veins is very large, at least one side of only 1 lumbar vein, up to 5, the most common case is 3, accounting for 36.7%. Variations in the location of the lumbar veins are also large, with no specific pattern of vertebral bodies. The probability of total co-intervention of the lumbar veins was greater than that of the arteries, which was 38.5%, while co-stemming from top to bottom also was a unique phenomenon of lumbar veins, with a total of 26, accounting for 12.5% ​​of the total. In addition, other variations of lumbar veins are common. CONCLUSIONS: Anatomical features of the lumbar and lumbar veins are of particular importance when selecting the approach to the left of the abdominal aorta or the inferior vena cava of the abdominal aorta during spinal surgery. The location of the artery is relatively constant, while the variability of the vein is large, the loss of common, about a total of dry, up and down a total of dry, large traffic branch between the veins common, and lumbar vertebral correspondence is not as good as the arteries, and the arteries are not strictly with OK, these reasons have caused the vein easy to cause injury, surgery should pay special attention.
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