【摘要】 目的 對骶正中動靜脈的位置分布及變異進行解剖觀察及實際測量其與周圍重要結構的位置關系，為臨床醫師提高腰骶椎前路手術安全性提供必要的參考信息。 方法 收集2008年5月-2011年1月期間因疾病及意外死亡者新鮮人體尸體標本30例，對其進行解剖學研究，觀察并測量骶正中動、靜脈的發出點與走行，骶正中動、靜脈的數量與缺失情況，以及骶正中動、靜脈間的相互走行關系。 結果 ①骶正中動脈在主動脈發出以及走行的位置相對固定，無明顯多支與缺失情況；骶正中動脈均為腹主動脈根部背側發出，未見發出點位于左右髂總動脈。發出后行于左側髂總靜脈后方，跨過腰5/骶1椎間盤下行。骶正中靜脈與骶正中動脈伴行的情況占總數的60.0%；②骶正中靜脈多支常見，沒有發現有骶正中靜脈的缺失。1支的占總標本數的66.7%，2支的占30.0%，3支的占3.3%。 結論 當選擇分叉下入路，應該特別注意骶正中動靜脈的解剖位置。動脈的變異相對較小，而靜脈的變異程度非常大，發出點變異，多支的情況多見，這些原因都造成了靜脈容易損傷的原因，在手術中應該特別注意。
【Abstract】 Objective To investigate the clinical significance of anatomical features of middle sacral artery and vein for lumbar-sacral spinal surgery. Methods We carried out anatomical research on 30 cadavers caused by diseases or accidents collected between May 2008 and January 2011. We dissected the vascular system anterior to lumbar vertebrae to learn their characteristics. The initial point of middle sacral artery and confluent point of veins, and the numbers of, and the companion relationship between middle sacral arteries and veins were chosen as the indexes to be measured. Results The middle sacral arteries started from the aorta, and their locations were relatively fixed without absence or multi-branches. All the middle sacral arteries derived from the dorsal side of abdominal artery root, and were not started from the common iliac artery. Then, the sacral arteries went at the back of left common iliac vein, and went down after traversing the inter-vertebral disk between the fifth lumbar and first sacral vertebra. About 60% of the middle sacral veins were accompanied with the arteries. Multi-branches of the middle sacral veins were frequently seen, and no absence was observed. One-branch, two-branch and three-branch middle sacral veins occupied 66.7%, 30.0% and 3.3% respectively out of the total. Conclusions When choosing downward branch approach during the operation, we should pay special attention to the anatomical locations of the middle sacral arteries and veins. Compared with the arteries, there are greater variations of the veins including variations of the confluent point and branches which can cause the veins to be quite vulnerable.
引用本文： 柏光澤,孔清權,李偉,王華. 骶正中動、靜脈解剖變異對脊柱腰骶椎前路手術的臨床意義. 華西醫學, 2011, 26(9): 1336-1338. doi: 復制