發(fā)布時間：2018-04-10 03:33

  本文選題：主動脈形態(tài)　切入點(diǎn)：主動脈夾層　出處：《中國臨床解剖學(xué)雜志》2016年06期

【摘要】：目的對A型夾層狀態(tài)下的頭臂血管進(jìn)行解剖學(xué)測量,為人工血管的制作和完善提供數(shù)據(jù)支持,為主動脈腔內(nèi)治療和頭頸部介入操作提供參考。方法對331例A型主動脈夾層的患者行回顧性CTA三維重建,并對其分別進(jìn)行形態(tài)描述,徑線和角度測量。結(jié)果共計331例,標(biāo)準(zhǔn)型主動脈弓91.5%(303例),變異型主動脈弓8.5%(28例)。25.4%(77例)3分支開口均低于主動脈弓最高點(diǎn)。3分支開口分布中,IA多見于后位,而LCCA和LSA則多見于中位。IA最易被夾層累及。由IA到LSA,3分支在開口處的直徑分別為(16.2±3.6)、(11.0±3.3)、(12.9±3.6)mm。3分支在距離開口2 cm處直徑分別為:(12.0±3.0)、(9.0±1.9)、(9.8±2.1)mm。IA-LCCA間距平均為(10.1±5.5)mm(2.0~20.0mm)。LCCA-LSA間距平均為(14.1±5.9)mm(2.0~27.0mm)。在主動脈弓冠狀面,頭臂血管與主動脈弓所成角分別為(62.5±26.5)°,(57.8±23.4)°,(64.9±23.5)°。在主動脈弓橫截面,頭臂血管與主動脈弓所成角分別為(121.1±24.7)°,(107.3±19.4)°,(100.5±16.1)°。結(jié)論通過本研究得到了A型夾層狀態(tài)下的頭臂血管詳細(xì)解剖數(shù)據(jù),且和目前流行的人工血管設(shè)計數(shù)據(jù)并不一致,這為人工血管進(jìn)一步完善提供了數(shù)據(jù)支持。
[Abstract]:Objective to measure the anatomy of head and arm vessels in type A dissection, to provide data support for the fabrication and improvement of artificial vessels, and to provide reference for endovascular treatment of aorta and interventional operation of head and neck.Methods three dimensional CTA reconstruction was performed in 331 patients with type A aortic dissection, and the morphologic description, diameter and angle were measured.Results there were 331 cases with standard aortic arch (91.5) and 303 cases with variant aortic arch (8.5g / kg). In 77 cases with variant aortic arch (8.5g / kg), the third branch opening was lower than that at the highest point of aortic arch (3.3branches) in posterior position, while LCCA and LSA were more likely to be involved by dissection in middle position (.IA).The diameter of the branches from IA to LSA-3 at the opening was 16.2 鹵3.6m (11.0 鹵3.3mm) and 12.9 鹵3.6)mm.3 (12.0 鹵3.0cm) from the opening to the opening, respectively. The diameter of the branches from IA to LSA-3 was 9.0 鹵1.9 鹵1.90 鹵1.89 鹵2.1)mm.IA-LCCA, respectively, and the average distance between them was 14.1 鹵5.9mm ~ 2.0mm ~ 27.0 mm ~ (-1).On the coronal plane of aortic arch, the angle between the vessels of the head and arm was 62.5 鹵26.5 擄and 57.8 鹵23.4 擄respectively.In the cross section of aortic arch, the angle between the vessels of the head and arm and the aortic arch was 121.1 鹵24.7 擄and 107.3 鹵19.4 擄/ 100.5 鹵16.1 擄respectively.Conclusion the detailed anatomical data of cephalic and brachial vessels in type A dissection were obtained in this study, which were not consistent with the prevailing design data of artificial blood vessels, which provided data support for further improvement of artificial blood vessels.
【作者單位】： 中國醫(yī)學(xué)科學(xué)院阜外醫(yī)院心外科;
【分類號】：R322.1

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