| Object: To study the associations of pelvic arteries" branches with pelvic sides and lumbosacral plexus .To study the mechanisms and methods of diagnose and treatment of the pelvic artery injuries.Method: The study was performed in 20 formalin-fixed specimens of Chinese cadaver's pel vises .We observed the relationship of the patterns of the iliac arterial branches and type with the pelvic ligments and sacral nerves, and observed the location of the pelvic vessels on the pelvic sides , and measured the vertical distance from vessels to pelvic sides ,and observed the collateral circulations of the pelvic arteries. The results were recorded by maping , taking pictures .The vertical distance from the pelvic arteries to pelvic sides was measured on the CT scans of 5 living bodes, who didn't suffer from vessel-diseases. We retrospectively reviewed the charts of 11 consective patients with the pelvic fractures and arterial injuries. The patients' ages ranged from 21 to 52 , and 7 were male, 4 were female. The injury mechanisms were motor vechicularin in 5,crush in4, falls in 2. The average amount of blood transfusion was 2500 ml. The patients whose bloodpressure were still low after antishock treatment were sent to angiography. The results were recorded.Result: 1. The results of anatomy: The diameter of the pelvic arteries which were shorter than 3 mm were iliaclumber artery, lateral sacral artery , obturator artery. The diameter of pelvic arteries from 3 to 5mm were superior gluteal artery, inferior gluteal artery, internal pudendal artery. The diameter of pelvic arteries which were bigger than 5mm were common artery, internal iliac artery, external iliac artery. The vertical distance from pelvic arteries to pelvic sides which were greater than 10mm were common iliac artery, internal iliac artery, external iliac artery, which were smaller than 10mm were iliaclumber artery, obututor artery, lateral sacral artery, superior gluteal artery, inferior gluteal artery. The differences had significant (p<0.05). The length of the left iliac common artery was 44.17+/-7.28mm, and the length of right iliac common artery was 41.28-f/-6.74mm.The left was longer than the right (p<0.05). The length of the left external iliac artery was 105.42+/-7.13mm, and the length of right external iliac artery was 11.63+/-7.23mm. The right was longer than the left (p<0.05). The diameter of the pelvic arteries which the left compared with the right had no significant differences. According to the classification by Zhong shizhen about the patterns of the branches of the internal iliac artery, the internal iliac arterywere classified into 5 types: type I was 22 sides (25%), type II 8 sides (17.5%),type III 8 sides (17.5%), type IV 2 sides (5%), type V 1 side (2.5%). In 87.5% cases the superior gluteal artery passed through iliaclumber plexus , and in 52.5% cases the inferior gluteal artery passed through iliaclumber plexus. In all the cases , we found the circumflex of iliaclumber-deepcircumflex artery.2. CT scan results: The arteries which the average distance from pelvic artery to pelvic sides was shorter than 10mm were obututor artery, superior gluteal artery, inferior gluteal artery, which was longer than 10mm were common iliac artery, internal iliac artery, external iliac artery. 3. Results of clinical cases: The 9 cases who suffered from pelvic fractures with the hemorrhage underwent pelvic angiography. The incidence of success was 100% and the systolic pressure was kept above 90 mmHg after selective artery embolization. After CT and X-ray were performed, the pelvic fractures were classified. According to Yongth-B ergess' dassifcation, type LC III was 2 cases , type APC II 2cases,type APC III 3 cases, type VS 1 case, type CM 1 case. The injured arteries were: internal iliac artery 2 cases, external iliac artery 2 cases, superior gluteal artery 3 cases, iliaclumber artery 1 case, inferior gluteal artery I case, obutator artery 2 cases, lateral sacral artery 1 case. The pelvic fractures were managed: external fixation 2 c... |
