骨盆骨折出血动脉栓塞的解剖学基础

目的：了解骨盆动脉侧枝吻合特点，探讨骨盆骨折损伤血管的动脉栓塞的方法。方法：20具新鲜成人骨盆，采用前后双侧入路解剖，观察髂内外血管的走行特点、各动脉间的侧枝吻合情况。结果：骨盆动脉起点口径小于3mm的血管有闭孔动脉、髂腰动脉、骶外侧动脉。骨盆动脉起点口径3～5mm的血管有臀上动脉、臀下动脉、阴部内动脉。骨盆动脉起点口径大于5mm的血管有髂总动脉、髂内动脉、髂外动脉。距骨壁距离大于10mm的血管有髂总动脉、髂内动脉、髂外动脉。距骨壁距离小于10mm的血管有闭孔动脉、髂腰动脉、骶外侧动脉、臀上动脉、臀下动脉。骨盆动脉分支间有广泛的吻合支。结论：骨盆骨折动脉损伤应栓塞损伤的动脉及其主要的侧枝循环。

Applied anatomy of embolization for injured arteries in pelvic fracture

Objective: To study the association of pelvic artery branches and to study the methods of embolization of the pelvic artery injuries. Methods: The study was performed in 20 specimens of Chinese cadaveric pelvises.The relationship of the patterns of the iliac arterial branches and the collateral circulations of the pelvic arteries were observed. Results: The diameter of the pelvic arteries shorter than 3 mm were iliaclumber artery, lateral sacral artery, obturator artery. The pelvic arteries with diameter from 3 to 5mm were superior gluteal artery, inferior gluteal artery, internal pudendal artery. The pelvic arteries with diameter longer than 5mm were common artery, internal iliac artery, external iliac artery. The arteries with vertical distance from pelvic arteries to pelvic sides greater than 10mm were common iliac artery, internal iliac artery, external iliac artery,smaller than 10mm were iliaclumber artery, obututor artery, lateral sacral artery, superior gluteal artery, inferior gluteal artery. The pelvic arteries had wide collateral circulations. Conclusion: The injured arteries and important collateral circulations should be embolized in pelvic fracture with arterial injuries.