下颌骨血供及血管构筑的临床解剖学研究

目的：研究下颌骨血供及其血管构筑，为下颌骨截骨术提供形态学基础。方法：15例新鲜头颈部标本，其中8例经颈总动脉注入红色过氯乙烯填充剂，经腐蚀后制成头部血管铸型标本；2例去除部分内侧骨皮质，显示下牙槽动脉的分支分布情况；其余5例注入5％明胶墨汁，经脱钙、漂白、乙醇梯度脱水和二甲苯透明后，用水杨酸甲酯继续透明和保存，观察下颌骨膜和骨内的血管构筑。结果：下颌骨内部主要由下牙槽动脉供血；下颌骨表面及骨膜则由下颌骨骨膜动脉和肌动脉骨穿支营养；下颌骨骨膜动脉和肌动脉骨穿支经过下颌骨副孔穿入下颌骨内，与下牙槽动脉分支互相吻合，使下颌骨骨内与骨周围软组织间构成丰富的血管交通构筑。结论：下颌骨截骨手术后移动骨块和施行骨内固定时，要尽量少剥离下颌骨周围的软组织，以避免下颌骨发生坏死。

The clinical anatomic study on the blood supplying system and its vessel architecture of the mandible

Objective: To explore the blood supplying system and its vessel architecture of the mandible and provide anatomic basis for osteotomy of mandible. Methods: 15 fresh adult head specimens were used. 10 of which were injected red chlorinated poly vinyl chloride into both common carotid artery by catheterization, 8 cases were used to make up head specimens with vessel casting mould after corroded the hard and soft tissue, and 2 cases were peel off part cortical bone and displayed branches and distribution of the inferior alveolar artery. The carbonic black ink containing 5% gelatin were injected into another 5 specimens, and decalcified with 5% hydrochloric acid and bleached with 3% hydrogen peroxide, then gradient dehydration was carried out, and the transparency of the bony tissue was performed by dimethylbenzene and deposited in methyl salicylate (holly oil). Finally the vessel architecture of the mandible was observed and measured by using above specimens. Results: The internal part of mandible was supplied by inferior alveolar artery. The external surface and periosteum of mandible was supplied by the periosteal arteries and the bony perforator of muscular artery, respectively. A rich vascular anastomosis and a three-dimensional vascular architecture of internal and external part of mandible were thereby established through the accessory foramen of the mandible. Conclusions: At the time of moving bone bulks and internal fix of the mandible after the mandibular osteotomy, the soft tissue around the mandible should be reserved as far as possible in order to avoid occurring of mandible necrosis.