中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (3): 254-259.doi: 10.13418/j.issn.1001-165x.2016.03.004

• 应用解剖 • 上一篇    下一篇

髌韧带与膝交叉韧带的血供及其在交叉韧带损伤重建中的意义

王守安1,    庄志强2, 王虎3   

  1. 1. 莆田学院基础医学部,  福建   莆田    351100;    2. 中山大学孙逸仙纪念医院,  广州   510120;
    3. 汕头大学医学院附属第一医院,  广东   汕头    515041
  • 收稿日期:2015-08-10 出版日期:2016-05-25 发布日期:2016-06-17
  • 通讯作者: 王虎,主任医师,Tel:(0754)88258290, E-mail:wanghu 101@126.com
  • 作者简介:王守安(1968-),男,黑龙江庆安人,教授,硕士,主要从事应用解剖方面的研究,Tel:(0594)2780151,E-mail:wangshouanjms @126.com
  • 基金资助:

    福建省教育厅科研项目(JB07157)

Cruciate ligaments of knee and patellar tendon of blood supply and clinical significance in reconstruction of damaged cruciate ligaments

WANG Shou-an1,  ZHUANG Zhi-qiang2, WANG Hu3   

  1. 1. Putian University Basic Medical Science Department, Putian, Fujian 351100, China;2. Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510515, China; 3. First Affiliated Hospital of Shantou University Medical College,  Shantou, Guangdong 515041, China
  • Received:2015-08-10 Online:2016-05-25 Published:2016-06-17

摘要:

目的 探讨髌韧带和膝交叉韧带的血供特点,为临床韧带重建提供形态学依据。   方法 通过成人和胎儿股动脉红色乳胶灌注并解剖剥离、胎儿墨汁灌注组织透明和组织切片等方法,观察髌韧带和膝交叉韧带的动脉分布特点并测量胎儿韧带内微血管密度。  结果 髌韧带的动脉来自膝下外动脉、胫前返动脉、膝降动脉和膝下内动脉的分支;胎儿髌韧带不同区域微血管密度不同,且以韧带中心部为最低。前、后交叉韧带的动脉分别来源于膝中动脉、髌下脂肪垫以及膝下外动脉的分支。多数韧带内血管沿长轴走行,同时也有横向交通的小血管,血管网呈梯状或平行的丛状。近侧端和远侧端较密而中间部相对稀疏。  结论 ①髌韧带和膝交叉韧带均存在中心部乏血管区;②韧带两端血供最丰富,且近侧段好于远侧段;③髌韧带血供优于膝交叉韧带,髌韧带重建交叉韧带具有血供基础。

关键词:  , 髌韧带, 膝交叉韧带, 血管构筑, 重建

Abstract:

Objective  To study the characteristics of the flow of blood in patellar tendon(PT) and cruciate ligament in order to provide the morphological basic data for ligament reconstruction in clinical medicine. Methods 42 cases of lower limb were selected, including 6 adults and 36 fetuses. The femoral artery of each limbs were first perfused with red latex and separated all the main blood vessels and other tissues (6 adults). Ink was injected into the arteries 30 fetuses, tissue sections were made and made transparent. The microvascular architecture of PT and cruciate ligament were observed and the blood capillary density of PT and cruciate ligament were measured under optical microscope. Ligaments of 6 fetal specimens were cut and made into HE sections, observed under optical microscope. Results The arteries of the PT comes from the branches of femoral artery; The microvascular density of foetal patella of different area varies. The distribution pattern of the arteries of the PT has the characteristic of low in intermediate while high on both sides. The artery of ACL and PCL is derived from the branch of the popliteal artery and patellar artery. Most of the blood vessels flow along the axis direction while some are crosswise, like a ladder and net-shaped at the same time. Conclusion ①Both of PT and cruciate ligament have a  weak vascular area to the center; ②The most abundant blood supply are on the both ends of the ligament, and near side is better than distal one; ③The blood supply of the PT is better than cruciate ligament, PT has the better bloodsupply in cruciate ligament reconstruction

Key words: Patellar tendon, Cruciate ligaments of knee, Angioarchitecture, Reconstruction