活体肾上腺血管的解剖观测及临床意义

目的：研究活体肾上腺血管的应用解剖。方法：对１８例２４侧肾上腺手术时分离出血管，测量血管外径及长度，对６个完整肾上腺灌注染色。结果：右膈下动脉从下腔静脉右缘至末支肾上腺上动脉长８．５（７．５～１１．０）ｃｍ，外径２．５～３．０ｍｍ；左膈下动脉从腹主动脉左缘至末支肾上腺上动脉长８．０（７．０～９．０）ｃｍ，外径２．５～３．１ｍｍ；肾上腺上动脉１～６支，均源于膈下动脉。肾上腺中动脉右侧长１．７～２．２ｃｍ，外径１．０～１．５ｍｍ；左侧长１．５～２．０ｃｍ，外径１．０～１．５ｍｍ。肾上腺下动脉两侧基本相同，长１．５～２．０ｃｍ，外径１．０～２．０ｍｍ。肾上腺中心静脉右侧长０．４～０．８ｃｍ，左侧长３．０～４．０ｃｍ，外径３．０～４．０ｍｍ。结论：肾上腺血管加部分膈下血管的长度可供带血管蒂肾上腺转位治疗柯兴氏病；活体切取供移植的肾上腺；选择性肾上腺血管造影等。     

腓肠内外侧血管解剖特点及其在小腿创伤修复中的意义

目的：为小腿创伤皮瓣移植修复与腓肠内、外侧血管吻合提供解剖学基础。方法：在７０侧成人下肢标本上解剖观测了腓肠内、外侧血管的长度、外径、血管神经的毗邻关系及其形态特点。结果：①腓肠内、外侧动脉起于动脉，伴行静脉注入静脉；②动脉起点至入肌段的长度内、外侧分别为４．１±０．７（１．８～６．４）ｃｍ、３．７±０．５（２．０～６．５）ｃｍ；③肌门处内、外侧动脉的外径分别为２．２±０．１（１．１～３．４）ｍｍ、２．０±０．１（０．９～３．１）ｍｍ；④肌门处伴行静脉有１～２条，内、外侧静脉外径为２．５±０．３（１．８～４．５）ｍｍ，２．３±０．３（１．５～４．１）ｍｍ。结论：腓肠内、外侧血管恒定、径粗、较长，是小腿创伤皮瓣移植修复受区可供应用的吻合血管     

以第1或第2穿动脉为蒂骨瓣转位重建股骨距的应用解剖

目的：为带血管蒂骨瓣转位重建股骨距提供解剖学依据。方法：３０侧经动脉内灌注红色乳胶的成人下肢标本，对第１、２穿动脉起始、走行、分支分布和骨膜支进行详细的解剖学观察。结果：股深动脉在小转子尖下４．５±１．３ｃｍ、９．３±２．７ｃｍ处分别发出第１、２穿动脉，外径分别为２．８±０．７ｍｍ、２．４±０．６ｍｍ。穿动脉发出１～３支外径在１．０ｍｍ以上的肌骨膜支，分布于股骨后部中上段骨膜。结论：可以第１或第２穿动脉为蒂设计股骨瓣，可转位重建股骨距或修复股骨颈。     

股骨头缺血性坏死介入治疗的应用解剖

目的：为股骨头缺血性坏死介入治疗提供解剖学基础。方法：在５０侧成人尸体上观察了股深动脉的类型，测量了各分支的长度和外径。结果：股深动脉主要从股动脉后方（６０％）和后外侧（２６％）发出，分为深全干型（６０％）、深外干型（２０％）、深内干型（１４％）和深孤独干型（６％）。各主要血管外径为：股深动脉５．７±１．６ｍｍ；旋股内侧动脉３．６±１．０ｍｍ，其升支２．０±０．９ｍｍ；旋股外侧动脉３．７±１．１ｍｍ，其升支２．５±０．８ｍｍ。结论：该项研究为提高股骨头缺血性坏死介入治疗的成功率提供了详尽的解剖学依据。     

踝跖部神经显微断层解剖及其临床意义

目的：为不同部位断足再植提供理论基础和有关数据。方法：用体视学方法对６６例成人踝跖部胫神经及其重要分支进行观测。结果：胫神经的平均横径和面积分别为：第１断层５．８ｍｍ，１４．１ｍｍ２，足底内侧神经的平均横径和面积分别为：第１断层４．０ｍｍ，７．２ｍｍ２，第２断层４．１ｍｍ，６．８ｍｍ２；第３断层４．３ｍｍ，６．５ｍｍ２；第４断层３．７ｍｍ，５．４ｍｍ２；第５断层３．１ｍｍ，４．４ｍｍ２；第６断层３．２ｍｍ，４．４ｍｍ２；第７断层２．９ｍｍ，４．７ｍｍ２。足底外侧神经的平均横径和面积分别为：第１断层３．０ｍｍ，４．８ｍｍ２；第２断层３．１ｍｍ，４．５ｍｍ２；第３断层３．５ｍｍ，４．７ｍｍ２；第４断层４．０ｍｍ，４．４ｍｍ２；第５断层４．５ｍｍ，４．６ｍｍ２。结论：提出了“三段”断足分型法。不同断层平面断足再植吻接神经时要首选吻接主干，但断层１１和１２应根据足部感觉功能需要首选吻接胫侧神经。     

胸腰椎脊柱韧带拉伸性能的实验研究

目的：测试胸腰段脊柱韧带拉伸性能。方法：采用７例新鲜青年男性尸体胸腰椎脊柱韧带，进行解剖学观察和力学测试，每个韧带的测试除外其它因素单一进行。记录最大载荷－位移曲线和韧带的形态、力学改变，峰值为韧带断裂的标志。结果：前纵韧带、后纵韧带、棘间、棘上韧带最大破坏载荷依次为：６５４±６３Ｎ，２９１±４９Ｎ，９８±４３Ｎ，３８５±９３Ｎ；最大位移依次为：１１．４±２．６ｍｍ，４．５±１．５ｍｍ，３．８±１２．２ｍｍ，１６．０±５．０ｍｍ；结构刚度依次为：６０．４Ｎ／ｍｍ，５６．２Ｎ／ｍｍ，２５．０Ｎ／ｍｍ，４０．５Ｎ／ｍｍ。结论：不同种韧带的解剖形态和生理特点不同，具有不同的生物力学特性。     

颈部血管医学影像学的应用解剖

用福尔马林液固定的成尸６５具（男６０，女５），结合超声诊断选择相同的测点，用卡尺测量了颈总动脉，颈内动脉，颈外动脉及椎动脉和颈内静脉及椎静脉的外径，用千分尺测量了动脉壁厚度，其中各动脉内径：颈总动脉近点为６．３±１．４ｍｍ；远点为６．９±１．５ｍｍ，颈内动脉为５．５±１．２ｍｍ，颈外动脉为４．６±０．７ｍｍ，椎动脉椎前部为３．７±０．７ｍｍ。并就尸体与活体成人１００例用美国产ＡＣＵＳＯＮ１２８型彩     

以股后皮神经及其营养血管为蒂皮瓣的应用解剖

目的：为膝后区带股后皮神经及其营养血管筋膜皮瓣提供解剖学基础。方法：在３２侧成人下肢标本上，对膝后区的股后皮神经及其营养血管进行详细观测。结果：股后皮神经在窝上角处的横径为１．７±０．６ｍｍ，在该区的干长为１６．１±２．３ｃｍ。营养动脉平均２．３（１～３）条，外径为０．８±０．３ｍｍ，分别来源于穿动脉的肌皮支（占４９．３％）和动脉的筋膜皮支（占５０．７％）。静脉回流有营养动脉的伴行静脉和浅静脉，外径分别为１．１±０．５ｍｍ和２．１±１．９ｍｍ。结论：该区的神经血管恒定，可制成带感觉的转位筋膜皮瓣，用以修复膝关节附近的软组织缺损。     

脊柱椎板厚度测量及其临床意义

目的：系统地提供颈、胸、腰椎椎板厚度值,为临床应用提供参考资料。方法：对１００例原配完整的脊柱骨标本椎板厚度进行了形态学测量。结果：颈椎板（Ｃ１除外）Ｃ４、Ｃ５最薄,为３．０±０．７ｍｍ,Ｃ２最厚为６．４±１．２ｍｍ,呈明显中部薄两端厚的趋势;胸椎板Ｔ６最薄为６．５±０．９ｍｍ,Ｔ１２最厚为７．６±１．１ｍｍ,厚度变化不明显,平均值６．８±１．０ｍｍ;腰椎板Ｌ５最薄为６．０±１．１ｍｍ,Ｌ１、Ｌ２最厚为７．７±１．１ｍｍ,Ｌ１～Ｌ５呈明显由厚变薄趋势,Ｌ５大于Ｓ１椎管后壁厚度。椎板厚度左右侧差异无显著性（Ｐ＞０．０５）,性别间差异Ｃ７～Ｌ３有显著性（Ｐ＜０．０５）,同序数椎板厚度男性均大于女性。结论：脊柱椎板厚度有明显的规律性,Ｃ３～Ｃ６为最薄段,Ｃ４、Ｃ５最薄,Ｔ１２～Ｌ３为最厚段,Ｌ１、Ｌ２最厚;而胸椎板厚度（Ｔ１～Ｔ１１）介于颈、腰椎之间     

带血供肱骨下段内侧骨（膜）瓣移位术的应用解剖

目的：为带血供肱骨下段骨瓣移位术提供解剖学基础。方法：４０侧成人上肢标本，观测尺侧下副动脉、尺侧返动脉的起始、走行、分支分布、骨膜支和吻合。结果：尺侧下副动脉距髁间连线上３．７±１．７ｃｍ始于肱动脉，外径１．８±０．４ｍｍ，长１．８±０．７ｃｍ，骨膜支１～３支，外径０．８±０．４ｍｍ分布肱骨下段内侧半骨膜。尺侧返动脉前干外径１．１±０．２ｍｍ。尺侧上副动脉、尺侧下副动脉、尺侧返动脉在肱骨内上髁附近互相吻合。结论：利用上述血管吻合关系，设计带血供的肱骨（膜）瓣或骨皮瓣，可移位修复肱骨中上段、尺、桡骨中段骨折骨不连。临床应用已取得良好效果。     

Variation in the Origin of Cystic Artery

In recent years, an extensive development in laproscopic surgery has made surgeons to obtain a clear appreciation and knowledge of variations in the blood supply of gall bladder. The study was done on specimens including 35 embalmed cadavers and 15 fresh postmortem specimens by dissection method at JSS Medical College. In the present study we observed that the cystic artery from right hepatic was seen only in 54% cases. Whereas from hepatic artery proper in 22%, from common hepatic in 12%, from gastroduodenal in 8%, and from superior mesenteric in 2% of cases. Cystic artery from superior mesenteric passes through head of pancreas. This variation is very important for surgeons during resection of pancreas. Because of very limited field of vision during laproscopic surgery, haemorrhage could be a problem if these variations are overlooked. Sound knowledge of cystic artery variations is helpful for surgeons while performing upper abdominal surgeries.     

Multiple variations of internal iliac artery – A case report

IntroductionInternal iliac artery (IIA) is the vessel predominantly supplying the pelvic viscera and the pelvic wall. The main stem of IIA is usually devoid of any branches. Its two divisions give rise to all its branches.MethodA case of multiple variations of IIA was noted during routine dissection of a male cadaver on the right side.ResultsInferior gluteal artery and middle rectal artery which are usually branches of the anterior division of IIA arose from the posterior division. Iliolumbar artery, usually a branch of the posterior division arose from the main stem of IIA. Obturator artery arose from external iliac artery instead of IIA.DiscussionThe knowledge of such variations aids in performing various surgical and radiological procedures in this region.     

选择性腹腔动脉、肠系膜上动脉、肾动脉及肠系膜下动脉造影的局部解剖学研究

本文利用70具成人尸体(男性40具,女性30具)进行了经股动脉插管至腹腔动脉、肠系膜上动脉、肾动脉及肠系膜下动脉之间的距离,各动脉的直径,以及用圆形分布理论统计分析各动脉干与主动脉腹部间的平均夹角,并对动脉干纵轴的方向,动脉起始部与脊柱的对应关系,动脉干的类型做了解剖学观察,并讨论了相应的临床意义。     

人心脏冠状动脉房室支与室房支的观察

解剖５０例成人心脏冠状动脉，观察由冠状动脉发出的分布于心房与心室的共同的动脉小干及其返支。由心房动脉支发出的返支向下越过冠状沟入心室壁的称炎这房室外，由心室动脉支发出的返支向上越过冠状沟入心房壁的称之为室房支。     

Coronary artery aneurysms and coronary artery fistula as a cause of angina pectoris

Coronary artery aneurysm is an uncommon disease. Coronary artery fistulae are infrequent congenital anomalies. A extremely rare case report of combination of coronary artery aneurysms and coronary artery fistula is presented with a brief literature review.     

Anatomy of renal arterial supply

A thorough knowledge of the variations of the renal artery has grown in importance with the increasing numbers of renal transplants, vascular reconstructions, and various surgical and radiologic techniques. The literature indicates that multiple renal arteries are found in 9- 76% of cadavers. The purpose of this study is to establish the incidence and characteristics of variations of renal arteries in Thais. A total of 267 Thai cadavers were dissected in the anatomy laboratory. The anatomical findings included: a single hilar artery in 82% of cases; double renal arteries in 17% of cases (one hilar artery with an upper polar artery occurred in 7%; two hilar arteries in 7%, and one hilar artery combined with one lower polar artery in 3%); and triple renal arteries occurred in 1% (two hilar arteries with one upper polar artery in 0.4% and two hilar arteries with one lower polar artery in 0.6%). In preparation for interventions, such as living renal donation, vascular reconstruction, renovascular hypertension, or radical nephrectomy, the results indicate that preoperative renal imaging is necessary and that operative techniques with attention to multiple renal arteries should be considered.     

胃网膜右动脉与胸廓内动脉在冠状动脉旁路术中应用的比较研究

目的：为将胃网膜右动脉应用于冠状动脉旁路术提供依据。方法：观测了３８具成人尸体的胃网膜后动脉和胸廓内动脉，并对其中３０例进行了组织学观察及体视学计量。     

胸腰段后髓动脉的起源及其临床意义

目的:为选择性脊髓血管造影和椎管内显微外科提供解剖学资料。方法:采用尸体标本30例,于节段性动脉内逐一注入红色乳胶,在完整脊髓上解剖观察。结果:每例脊髓胸腰段的后髓动脉数目5～13支,平均8.4支。后髓动脉起始情况分3型10亚型,其中后髓动脉与前髓动脉由同一肋间后动脉发出仅34支(13.5％)。胸下部及腰部后髓动脉呈典型“发卡”样折曲。后髓动脉平均外径0.37±0.12mm。约1/3标本在T_(11)～L_3间有1支后髓动脉较粗(>0.5mm),它是脊髓后下部血供的主要来源。结论:多数后髓动脉单独起始,较大的后髓动脉应引起注意。     

老年组与中成年组髂外动脉的形态学比较

本文观微和测量了50具国人髂外动脉(左右合计100侧),并将所有观测项目按年龄分为老年组(60岁以上者)和中成年组(19—60岁)进行了统计学处理。结果发现:髂外动脉的长度、外径、髂外动脉与髂内动脉之间的夹角以及髂外动脉的弯曲程度在老年组与中成年组之间均有高度显著性差异。     

Variations of the arterial pattern in the upper limb revisited: a morphological and statistical study, with a review of the literature

A total of 192 embalmed cadavers were examined in order to present a detailed study of arterial variations in the upper limb and a meta-analysis of them. The variable terminology previously used was unified into a homogenous and complete classification, with 12 categories covering all the previously reported variant patterns of the arm and forearm.