股静脉作为血管移植材料可行性与安全性的应用解剖研究

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目的探讨股静脉作为血管移植材料的可行性与安全性。方法取60具成人尸体共114侧下肢标本,解剖观察股静脉、股深静脉、腘静脉及静脉交通支,测量股深静脉汇入股静脉处至收肌腱裂孔下缘的股静脉段长度,即股静脉可切取的解剖长度,以及静脉压扁外径。分析2010年3月-2011年5月收治的120例下肢股静脉段血栓形成患者CT静脉造影(computed tomography venography,CTV)检查资料,观察其下肢静脉回流通路。结果男性尸体身高平均158.3 cm,股静脉可切取长度为(18.8±2.3)cm,相对长度为0.118±0.013,静脉压扁外径为(15.8±0.8)mm;女性尸体分别为149.2 cm、(15.1±1.5)cm、0.101±0.010、(14.0±1.1)mm。男女股静脉可切取长度比较,差异有统计学意义(t=6.354,P=0.000);静脉压扁外径比较差异有统计学意义(t=5.555,P=0.000)。股静脉可切取长度与身高成正相关(r=0.964,P=0.000),股静脉压扁外径与身高成正相关(r=0.382,P=0.003)。解剖观察见16侧(14.0%)肢体存在双股静脉变异支,48侧(42.1%)肢体存在1支股-腘静脉交通支,38侧(33.3%)肢体存在1支股深-腘静脉交通支。CTV检查示,下肢股静脉血栓形成以后,大隐静脉及股-腘或股深-腘静脉交通支可代偿股静脉。结论大隐静脉和股-腘静脉交通支或股深-腘静脉交通支的存在,保证了切取股静脉作为血管移植材料的可靠性及安全性。 Objective To investigate the feasibility and safety of femoral vein as a vascular graft material. Methods A total of 114 adult cadaveric lower extremities were taken from 60 adult cadavers. The femoral vein, deep femoral vein, popliteal vein and vein were dissected. The length of the femoral vein at the inferior margin of the tendon rupture was measured, The anatomical length of the femoral vein that can be dissected, and the venous diameter of the vein. The CT venography (CTV) examination data of 120 patients with lower extremity femoral vein thrombosis admitted from March 2010 to May 2011 were analyzed to observe the venous return path of the lower extremity. Results The average height of male corpses was 158.3 cm, the length of femoral vein was (18.8 ± 2.3) cm, the relative length was 0.118 ± 0.013, and the diameter of vein was (15.8 ± 0.8) mm. The female bodies were 149.2 cm and 15.1 ± 1.5) cm, 0.101 ± 0.010, (14.0 ± 1.1) mm. The length of incision of femoral vein of male and female were compared, the difference was statistically significant (t = 6.354, P = 0.000). The difference of venous flattening diameter was statistically significant (t = 5.555, P = 0.000). The length of femoral vein was positively correlated with height (r = 0.964, P = 0.000). The diameter of femoral vein was positively correlated with height (r = 0.382, P = 0.003). Anatomical observation showed that 16 limbs (14.0%) had bilateral varicose veins in limbs, 48 ​​limbs (42.1%) had limbs in 1 limb - veins, 38 (33.3%) had limbs in 1 limb and had deep plexus veins support. CTV examination showed that after the formation of lower extremity femoral vein thrombosis, the saphenous vein and femoral 腘 or femoral deep 腘 vein traffic branch can replace the femoral vein. Conclusion The existence of the saphenous vein and branch of femoral vein or femoral vein or branch of femoral vein can ensure the reliability and safety of femoral vein as a vascular graft.
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