Cov hlab ntsha iliac yog ib cov hlab ntsha loj tshaj plaws hauv lub cev. Lawv tau ua ke cov hlab ntsha mus txog 7 cm ntev thiab mus txog 13 mm inch. Qhov pib ntawm cov hlab ntsha yog nyob rau hauv cheeb tsam ntawm 4th lumbar vertebra thiab yog ib qho txuas ntxiv ntawm lub plab aorta (nws bifurcation).
Qhov twg cov pob txha sacrum thiab cov pob txha iliac nyob, cov hlab ntsha no faib rau sab nraud thiab sab hauv cov hlab ntsha.
Common iliac hlab ntsha
Ntxim qab kawg li os.
Nyob hauv thaj tsam ntawm iliac-sacral sib koom ua ke, cov hlab ntsha iliac feem ntau faib rau hauv cov hlab ntsha sab hauv thiab sab nraud ntawm tib lub npe, ua raws li tus ncej puab thiab lub plab me me.
A. iliaca interna
Cov hlab ntsha sab hauv iliac (2) pub cov kabmob thiab cov phab ntsa ntawm lub plab mog. Nws nqis los rau sab hauv ntawm lub lumbar (loj) cov leeg.
Nyob rau sab sauv ntawm lub sciatic foramen, cov hlab ntsha parietal thiab visceral tawm ntawm lub nkoj.
phab ntsa
- Lumboiliac ceg (3). Ua raws li tom qab thiab tom qab psoas cov leeg loj, muab cov ceg rau iliaccov leeg thiab cov pob txha ntawm tib lub npe, nrog rau cov plaub hau thiab lumbar loj cov leeg. Tsis tas li ntawd, lawv muab cov ntshav rau daim nyias nyias thiab cov hlab ntsha ntawm tus txha caj qaum.
- Sacral lateral arteries (4). Nourish cov leeg sib sib zog nqus ntawm sab nraub qaum, sacrum, qaum qaum (cov hlab ntsha hauv paus thiab sheaths), ligaments ntawm coccyx thiab sacrum, cov leeg piriformis, cov leeg uas tsa lub qhov quav.
- Obturator hlab ntsha (6). Nws ua raws li pem hauv ntej ntawm ob sab ntawm lub plab me me. Cov ceg ntawm cov hlab ntsha no yog: pubic, anterior, posterior cov hlab ntsha uas pub cov tawv nqaij ntawm qhov chaw mos, obturator thiab adductor cov leeg ntawm tus ncej puab, lub duav sib koom, femur (nws lub taub hau), pubic symphysis, lub ilium, nyias, zuag, lumboiliac, cov leeg plaub hau, obturator (sab nrauv, sab hauv) cov leeg thiab cov leeg uas tsa lub qhov quav.
- Gluteal inferior artery (7). Nws tawm ntawm lub plab mog los ntawm qhov qhib piriform. Nourishes daim tawv nqaij nyob rau hauv lub gluteal cheeb tsam, lub duav sib koom, square, semimembranosus, gluteus maximus, piriformis, semitendinosus, adductor (loj) cov leeg, ntxaib (qis, sab sauv), obturator (sab hauv, sab nraud) cov leeg thiab cov nqaij biceps femoris (nws ntev. taub hau).
- Gluteal superior artery (5). Nws ua raws tom qab thiab dhau los ntawm suprapiriform qhib rau cov leeg thiab daim tawv nqaij ntawm thaj av gluteal nyob rau hauv daim ntawv ntawm cov ceg sib sib zog nqus thiab superficial. Cov hlab ntsha no txhawb nqa cov leeg me me, nruab nrab gluteal cov leeg, lub duav sib koom ua ke, daim tawv nqaij ntawm lub pob tw.
Visceral ceg
- Umbilical artery (13, 14). Khiav raws lub posterior nto ntawm lub plab phab ntsa, nce mus raudab teg. Thaum lub sijhawm cev xeeb tub, cov hlab ntsha no ua haujlwm tag nrho. Tom qab yug me nyuam, qhov tseem ceeb ntawm nws pib khoob thiab dhau los ua lub plab ligament. Txawm li cas los xij, ib feem me me ntawm lub nkoj tseem ua haujlwm thiab muab cov hlab ntsha zoo tshaj plaws thiab cov hlab ntsha ntawm vas deferens, uas pub cov phab ntsa tom kawg, nrog rau lub zais zis thiab cov phab ntsa ntawm lub ureter.
- Uterine hlab ntsha. Nws ua raws nruab nrab ntawm cov nplooj ntawv ntawm qhov dav uterine ligament mus rau lub tsev menyuam, hla txoj hauv kev nrog lub ureter thiab muab cov tubal, zes qe menyuam thiab qhov chaw mos ceg. R.tubarius nourishes cov hlab ntsha, r. ovaricus los ntawm lub thickness ntawm lub mesentery mus rau zes qe menyuam thiab tsim ib tug anastomosis nrog ceg ntawm zes qe menyuam hlab ntsha. Rr. vaginales ua raws li cov phab ntsa ntawm qhov chaw mos (lateral).
- Rectal (middle) hlab ntsha (9). Ua raws li lub qhov quav (phab ntsa sab nraud ntawm nws lub ampulla), txhawb nqa cov leeg nqaij uas tsa lub qhov quav, ureter, qis thiab nruab nrab ntawm qhov quav, hauv cov poj niam - qhov chaw mos, thiab hauv cov txiv neej - lub prostate thiab seminal vesicles.
- Genital (internal) artery (10) - ceg kawg ntawm lub iliac internal artery. Cov hlab ntsha tawm, nrog rau gluteal inferior artery los ntawm subpiri-puab foramen, khoov ib ncig ntawm lub ischial qaum, rov nkag mus rau hauv lub plab me me (hauv thaj tsam ntawm recto-sciatic fossa) los ntawm ischial (me) foramen. Nyob rau hauv no fossa, cov hlab ntsha muab tawm lub qhov quav inferior artery (11), thiab ces ceg mus rau hauv: lub dorsal noov (clitoris) artery, lub perineal, urethral hlab ntsha, lub tob clitoral (noov) hlab ntsha, lub hlab ntsha uas pub lub qhov muag teev. qhov chaw mos thiab cov hlab ntsha uas pub lub teeb ntawm lub vestibule ntawm qhov chaw mos. Tag nrho cov hlab ntsha saum toj nonoj cov khoom nruab nrog cev (obturator internus, sab qhov quav, qhov chaw mos sab nraud, qhov chaw mos, qhov quav, cov qog nqaij hlav, qhov chaw mos, cov leeg nqaij thiab daim tawv nqaij ntawm perineum).
A. Iliaca externa
Cov hlab ntsha sab nraud tuaj ntawm lub iliosacral sib koom ua ke thiab yog ib qho txuas ntxiv ntawm cov hlab ntsha iliac.
Ua raws li cov hlab ntsha iliac (cim nrog tus xub) downwards thiab anteriorly raws li sab hauv ntawm lub lumbar loj cov leeg mus rau inguinal ligament, dhau los ntawm lub vascular lacuna, nws hloov mus rau hauv cov hlab ntsha ntawm tus ncej puab. Cov ceg los ntawm sab nraud iliac hlab ntsha muab lub labia thiab pubis, scrotum, cov leeg iliac, thiab cov leeg plab.
Txiv kab mob sab nraud iliac artery
- Inferior epigastric artery (1). Nws ua raws li medially thiab tom qab ntawd nce lub plab plab (nws qhov posterior). Lub nkoj muab tawm ob peb ceg: cov hlab ntsha pubic, uas pub lub periosteum thiab pubic pob txha; cremaster artery (txog nyob rau hauv cheeb tsam ntawm lub sib sib zog nqus inguinal nplhaib nyob rau hauv cov txiv neej), uas pub cov membranes ntawm cov noob qes ntawm cov spermatic qaum thiab cov leeg, uas tsa lub noob qes los yog cov hlab ntsha ntawm lub round uterine ligament (nyob rau hauv cov poj niam), mus rau lub daim tawv nqaij ntawm qhov chaw mos.
- Cov hlab ntsha tob uas mus ncig ntawm ilium (2). Nws tshwm sim los ntawm nyob rau hauv lub ligament inguinal thiab sedates sab nraud thiab upward parallel mus rau lub iliac crest, tsim ib tug anastomosis nrog ceg los ntawm lub lumboiliac hlab ntsha. Cov hlab ntsha sib sib zog nqus pub rau phab ntsa(anterior) plab thiab nws cov leeg nqaij: iliac, transverse, tailor, oblique, thiab kuj straining lub fascia lata ntawm tus ncej puab.
YIliac artery occlusion
Qhov ua rau occlusion / stenosis ntawm cov hlab ntsha no yog qhov muaj aortoarteritis, thromboangiitis obliterans, cov leeg nqaij fibrous dysplasia thiab atherosclerosis.
Qhov tshwm sim ntawm cov kab mob no ua rau cov ntaub so ntswg hypoxia thiab cov ntaub so ntswg metabolism tsis zoo, thiab, vim li ntawd, mus rau kev loj hlob ntawm metabolic acidosis thiab tsub zuj zuj ntawm metabolic underoxidized khoom. Cov khoom ntawm platelets hloov, vim li ntawd, cov ntshav viscosity nce thiab ntau cov ntshav txhaws.
Muaj ntau hom occlusion (raws li etiology):
- Post-traumatic.
- Postembolic.
- Iatrogenic.
- Aortitis nonspecific.
- sib xyaw cov ntawv ntawm atherosclerosis, aortitis thiab arteritis.
Raws li qhov xwm txheej ntawm kev puas tsuaj rau cov hlab ntsha iliac, lawv txawv:
- txheej txheem mob.
- Stenosis.
- mob thrombosis.
Cov kab mob no yog tus yam ntxwv los ntawm ntau tus mob:
- Ischemia ntawm qis extremities (zoo li txias ob txhais ceg, sib quas ntus claudication, loog loog, nkees thiab paresthesia).
- Impotence (ischemia ntawm cov kabmob hauv plab pelvis, cov ntshav tsis txaus rau tus txha caj qaum (nws qhov qis dua)).
Occlusion yog kho nrog ob qho tib si kev saib xyuas thiab kev phais.
kev kho mobNws yog tsom rau optimizing ntshav coagulation, tshem tawm qhov mob thiab vasospasm. Rau qhov no, ganglionic blockers, antispasmodics, thiab hais txog.
Yog tias mob hnyav heev, mob thaum so, cov ntaub so ntswg necrosis, embolism, kev phais mob yog siv. Nyob rau hauv cov ntaub ntawv no, qhov puas ntawm cov hlab ntsha iliac raug tshem tawm, tshem tawm cov quav hniav, sympathectomy, los yog ua ke ntawm ntau yam txuj ci.
Iliac artery aneurysms
Thawj asymptomatic, thiab tsuas yog tom qab qhov nce tseem ceeb pib tshwm sim hauv kev kho mob.
Aneurysm yog ib lub hnab zoo li cov phab ntsa vascular, vim tias cov ntaub so ntswg elasticity txo qis thiab hloov los ntawm cov ntaub so ntswg loj hlob.
Aneurysm tuaj yeem tshwm sim los ntawm: atherosclerosis ntawm cov hlab ntsha iliac, raug mob, HD.
Cov kab mob no yog qhov txaus ntshai rau kev txhim kho ntawm cov teeb meem loj heev - aneurysm rupture, uas yog nrog los ntawm los ntshav loj, txo cov ntshav siab, lub plawv dhia thiab kev sib tsoo.
Thaum muaj kev cuam tshuam ntawm cov hlab ntsha hauv thaj tsam aneurysm, thrombosis ntawm cov hlab ntsha ntawm tus ncej puab, sab ceg thiab lub plab me me tuaj yeem txhim kho, uas yog nrog dysuria thiab mob hnyav.
Cov kab mob no tau kuaj pom siv ultrasound, CT lossis MRI, angiography thiab duplex scanning.
