【摘要】 目的探讨下腰椎侧方手术入路中减少动脉出血的方法。方法显微镜下解剖观测21具成人尸体的下腰椎节段动脉(lower lumbar segmental artery,LLSA)的起点至横突前的走行、分支、外径及其与椎间孔及横突前区的关系。结果LLSA出现率差异较大;腰3节段动脉(L3A,下同)和腰4节段动脉(L4A,下同)椎体侧方走行较恒定,腰5节段动脉(L5A,下同)走行变异较大;L3A及L4A主干及其分支多分别行于L3椎弓根外侧缘(71.43%)和L4/5椎间孔上1/3处(62.07%);在横突前区,L3A和L4A的横突前支多分别由横突间隙上1/3内侧斜向外下达中1/3外侧(60%)及由上1/3向下达下1/3处(58.33%)。结论重视处理腰椎体侧方、椎间孔附近及横突前区的动脉是减少术中出血的有效方法。更多还原

【Abstract】 Objective Explore the method to reduce arterial bleeding in the lower lumbar lateral surgical approach.Methods Anatomical observation arteries of lower lumber vertebrae of 21 dissected adult corpses under a microscope from their origin to the processus transversus-the routes,branches,exterior diameter of these arteries and their relationship with the intervertebral foramen and prezone of processus transversus.Results Different lumbar arteries appear in different rates here.The appearance rates of L3A and L4A remain constant while that of L5A is quite variable.The main trunks and branches of L3A and L4A are distributed at the rate of 71.43% in the of the lateral border of the pedicle of vertebral arch of L3A and 62.07% in the 1/3 of intervertebral foramen of L4/5A.In the prezone of processus transversus,the anterior branches of L3A and L4A originate mostly from the inner side of point upper 1/3,then slants outward down to the outer side of middle point 1/3 at the rate of 60% or from the upper1/3 point down to the lower 1/3 point at the rate of 58.33%.Conclusion A good treatment of the arteries near the lumbar vertebrae,intervertebral foramen and those in the prezone of processus transversus is an effective way to reduce bleeding in a certain operation.更多还原