离体肝脏出入静脉关系及临床应用解剖研究.docVIP

离体肝脏出入静脉关系及临床应用解剖研究 　　[摘要] 目的:探讨肝静脉属支与肝门静脉分支之间的关系及汇入下腔静脉肝后段的情况,为临床建立肝内门-腔静脉分流术或经下腔静脉肝后段肝内穿刺、肝静脉造影提供解剖学依据。方法:选取离体的肝脏标本40例,通过开放性实验进行解剖,分别测量肝静脉属支(左、中、右静脉)与门静脉左、右支的长度、直径及其之间的距离,并观察汇入下腔静脉肝后段的情况。结果:肝左静脉长度及直径分别为(38.22±15.41) mm和(6.34±1.45) mm;肝中静脉长度及直径分别为(40.61±14.80) mm和(5.83±1.37) mm;肝右静脉长度及直径分别为(50.12±10.46) mm和(7.65±1.52) mm;门静脉主干长度及直径分别为(74.51±6.07) mm和(8.16±3.22) mm,左支长度及直径分别为(9.30±2.11) mm和(6.08±1.86) mm;右支长度及直径分别为(12.24±2.67) mm和(7.53±2.04) mm;门静脉右干末段距离肝右静脉(17.30±8.53) mm,门静脉左干末段距离肝左、中静脉(20.61±9.10) mm及(18.94±8.72) mm;其中,肝左、中静脉合干汇入下腔静脉18例,肝左、中、右静脉单干汇入13例,肝中、右静脉合干汇入9例。结论:肝静脉右支的长度与直径均比左、中支长度与直径粗大,与肝门静脉右支间距离更近,肝内门-腔静脉分流术应首选肝右静脉与门静脉右干末段或分支间进行穿刺;经下腔静脉肝内穿刺、肝静脉造影时需先观察肝静脉属支汇入下腔静脉的组合类型再行操作。 　　[关键词] 肝静脉;门静脉;肝内门-腔静脉分流术;经下腔静脉肝内穿刺;肝静脉造影 　　[中图分类号] R322.1+2[文献标识码]A [文章编号]1673-7210(2010)05(a)-012-03 　　 　　Study of the r elationship between retrohepatic in and out veins of isolated liver and clinical anatomy 　　SUN Shizhu, SHEN Lei, LI Yongtao, LI Gongqi, LI Jingping 　　(Department of Anotomy, Qiqihar Medical College, Qiqihar 161006, China) 　　[Abstract] Objective: To explore the relationship between the branches of hepatic veins and hepatic portal vein branches and import retrohepatic inferior vena cava situation, and provide anatomical basis for the clinical establishment of intrahepatic portal-caval shunt or retrohepatic inferior vena cava puncture and hepatic venography. Methods: A total of 40 specimens were selected from the isolated liver, hepatic venous branches of the main (left, middle and right veins) and portal vein of left and right branch length, diameter and the distance were measured through an open laboratory dissection, then the import retrohepatic inferior vena cava situation was observed. Results: Lengths and diameters of the left, middle and right hepatic veins (LHV, MHV and RHV) were (38.22±15.41) mm and (6.34±1.45) mm; (40.61±14.80) mm and (5.83±1.37) mm; (50.12±10.46) mm and (7.65±1.52) mm respectively; length and diameter of portal vein were (74.51±6.07