【作者】 原晓景；

【导师】 徐达传；

【作者基本信息】 第一军医大学 ， 临床解剖学， 2006， 博士

【摘要】 目的和意义 髋关节是人体最大的臼杵关节，由髋臼和股骨头通过韧带连接构成。髋关节是连接躯干和下肢的枢纽，其主要功能是承重，在站立、行走、跑步时为身体提供稳定的基础。有关髋关节血液供应的研究已有一百多年的历史。髋关节的血液供应主要来源于两大动脉系统：髋臼的血液供应主要来自髂内动脉的分支，股骨头颈的血运主要由来自股动脉和股深动脉的分支。两大动脉系统之间在股骨头颈及髋关节囊等部位存在广泛的吻合，为髋关节提供了丰富的血液供应。髋关节外科一直是骨科的重要组成部分，近年来髋关节外科得到了迅速的发展，年手术量有不断增加的趋势；针对髋关节的手术入路也在不断的改进和完善。但是，各种手术入路对髋关节血供的影响尚缺乏深入研究，不同疾病手术入路的选择主要依据病变的部位和手术者的习惯，缺乏明确的解剖学依据。在保留股骨头的手术中，选择哪种手术入路可最大限度地减少对股骨头血供的进一步破坏，还需做进一步的探讨。有关髋关节周围血液供应的研究方法既包括传统的解剖学研究，也有新兴的DSA、CT等影像学研究，近年来螺旋CT及MRI也在血管的研究方面发挥了重要的作用，但是在髋关节方面的研究较少。因此，有必要采用多种技术对髋关节周围的血液供应进行系统深入地研究。 方法 1．在灌注标本上，经沿髂嵴至耻骨结节去除前腹壁肌肉，解剖髂内、外动脉及其发至髋关节周围的分支。去除盆腔内髂肌、腰大肌、梨状肌及静脉分支，经髋关节前、外、后方逐层去除髋关节周围肌肉，仔细解剖出髂内动脉系统的臀上、下动脉、闭孔动脉及其分支和髂外动脉系统的股动脉，股深动脉发出的第1穿支、旋股内侧动脉和旋股外侧动脉。测量各主要知名动脉起点的口径，更多还原

【Abstract】 Objective and SignificanceHip joint is the largest spheroidal joint of human body. It is connected by the acetabulum, which is formed by the ilium, and the femoral head through the ligaments. Hip is the hinge connecting the lower limbs to the trunk, the main function of which is weight bearing to provide stable foundation for the body while standing, walking and running The study about blood supply of hip has an over 100 years’ history. The arteries supplying the hip mainly originate from two major artery systems. The blood supply of acetabulum mainly comes from the branches of the internal iliac artery while that of femoral head and neck comes from the branches of the femoral artery and the deep femoral artery which are arise from the external iliac artery. There are extensive anastomoses between the two artery systems in their distribution of the femoral head and neck, capsula articularis coxae, etc, providing the hip ample blood supply. Hip surgery is always an important part of orthopedics. It has achieved prompt progress in recent years, the amount of operation of which has a constantly increasing tendency. Approaches to the hip have been continuously improved and consummated. But the effects on the blood supply to the hip are still lack of further profound research. The choice of different approaches is according to the lesion location and the operator’s habits but short of definite anatomic evidence. In the operation to reserve the femoral head, it needs further investigations to choose the approach that can utmost reduce further destroy to the blood supply of the femoral head. The methods to study the blood supply of hip include not only traditional更多还原